Background: The Tobacco Control Law in Vietnam was adopted in 2012 and came into force from May 2013, followed by a number of guiding sub-law legal documents. Smoke-free campus policy in university is considered an important measure to protect people from secondhand smoking as well as staffs and students will be in favour of the policy. Furthermore, there has been evidence suggested that smoke-free policy had positive impact on active smoking as well as anti-smoking attitude.

Methods: A cross-sectional self-administered study of staff at 4 universities were conducted in 2 phases, Phase 1 as early introduction of the Law (n = 900) and Phase 2 as 1-year post (n = 885). Demographics, tobacco consumption, compliance status and compliance with awareness towards the campus smoking regulations were assessed in both phases.

Results: Daily smoking prevalence decreased significantly (P < .05) 1 year after implementing the smoke-free policy, while a significant increase in occasional smoking (P < .01). Compliance of staff to the regulation the campus should be indoor smoke-free was significantly increase at Phase 2 compared to Phase 1, however participants reported there would be places on campus that smokers frequently violated the smoke-free regulations.

Conclusions: The study indicated a significant positive change in compliance of staff at the 4 universities after the implementation of the Tobacco Control Law, included the smoke-free policy. Although the prevalence of tobacco smoking in this study was low, the proportion of respondents who reported to reduce infringement the smoke-free policy suggests support for staff smokers would be beneficial. Raising awareness and enforcement is likely to enhance the long-term outcomes of the implementation of smoke-free environment.

The lack of regulation and adequate testing of talc-containing personal care products in the U.S. has resulted in the contamination of cosmetics with asbestos. As such, the true exposure of consumers to asbestos is poorly characterized and likely underestimated. In this study, transmission electron microscopy analysis revealed that 3 of 21 powder-based cosmetic products tested were contaminated with amphibole asbestos. One of these contaminated products is expressly marketed for use by children. The presence of asbestos found in products demonstrates the urgency to revise cosmetics policy. Further, talc-based cosmetics may be an overlooked and difficult to characterize source of exposure to asbestos, a known carcinogen.

Aedes (Stegomyia) aegypti (Linnaeus, 1762) is one of the world’s most widely distributed mosquitoes and is the vector of the dengue virus, one of the most important reemerging diseases. Besides dengue, A. aegypti can also transmit urban yellow fever, chikungunya, and Zika virus, making it of great medical importance. Thus, it is of extreme importance to find reliable methods to evaluate the presence of A. aegypti in urban areas. In Brazil, rapid index surveys of Aedes aegypti by means of larval survey (LIRAa) is the official method to estimate the Breteau (BI) and property infestation (PII) indexes, which indicates how many infested containers with larvae of A. aegypti were found by the total number of properties surveyed and the proportion of houses infested, respectively. As the LIRAa requires access to private residences and trained personal to find breeding sites and do not reveal the mosquito’s presence when in low density, it has not demonstrated efficacy in determining the presence of A. aegypti. To evaluate an alternative method, the LIRAa method was compared with an oviposition trap, made with hay infusion and a hardboard pallet, to evaluate the BI and the PII. The 2 methods were carried out simultaneously through 4 surveys, sampling 60 homes per survey. To evaluate the best configuration of ovitraps for surveillance of A. aegypti, the ovitraps were installed in intradomicile and peridomicile areas, with 1 to 5 traps per residence and with 1 to 3 pallets per trap, and these different configurations were compared using the positive ovitrap index (POI) and egg density index (EDI). The ovitraps showed greater sensitivity for detecting the presence of A. aegypti, with a BI of 72.5% and PII of 54.2%, whereas the LIRAa revealed only 2.1% for the BI and 1.3% for the PII. Therefore, the use of sentinel traps can provide information in a more rapid and precise manner. As there were no differences in the ovitraps distributions patterns, the ovitraps can be installed in the peridomicile area, with 2 traps per surveillance point and 1 pallet per trap, making their installation easier and more cost-efficient, facilitating the work of health agents in future surveillances complementing LIRAa’s actions for efficient monitoring.

In the Midwestern United States (US), river flooding is a climate change-related hazard that poses a significant threat to health, well-being and economic stability. The 2019 Midwest floods led to major flooding at every monitoring site along the Mississippi River, set record water levels at 42 sites, and resulted in an estimated $6.2 billion in infrastructure damage and recovery costs. Although the risks associated with increasing flooding in the Midwestern US have been well recognized, less is known about the adaptation challenges and opportunities in the region, particularly in the Upper Mississippi River Basin. This exploratory study examined stakeholder perspectives on river system management, flood risk reduction, and adaptation planning in the Upper Mississippi River Basin. We conducted in-depth interviews with flood management stakeholders between August and October 2019. Interview data were analyzed using thematic analysis. Five themes emerged from the interviews: (1) River flooding in the Midwestern US is a different experience than US coastal flooding; (2) River flooding in the Midwestern US is a regional experience that requires a regional response; (3) Local actors face constrained resources for flood risk protection and recovery; (4) Differentiated responsibility across levels of governments makes recovery and response difficult to navigate; and (5) Competing stakeholder goals challenge cooperative flood hazard management. Overall, these results suggest that locally focused adaptation efforts, while perhaps appropriate for coastal communities or more urban contexts, are suboptimal strategies for communities in the flood-prone river basins of the Midwestern US. Instead, structures and support for regional collaboration should be considered and pursued.

INTRODUCTION: Air pollution can adversely affect the health of communities and manifest as a variety of symptoms.

OBJECTIVE: This study aimed at assessing health symptoms among populations living near an oil refinery in Jordan.

METHODS: A cross-sectional survey study was conducted utilizing convenient random sampling at Al-Hashimeya town (where the refinery is located) and Bal’ma town (about 12 km further away from refinery). A total of 486 participants were recruited for the study. The data were checked, coded, and entered to excel sheet and exported to the Statistical Package for Social Science (SPSS) Version 20 for further analysis. Both bivariate and multivariate logistic regressions were used to identify associated factors. Variables having a P ⩽ 0.25 were fitted to multivariate logistic regression so as to assess the presence and strength of associations between socio-demographic characteristics and health symptoms and outcomes. A P value < 0.05 was considered for statistical significance.

RESULTS: In the cross tabulation analysis, there were significant differences in the reported respiratory health problems and history of abortions in the family between residents in the 2 towns (P < 0.05). Only 4.7% of Al-Hashimeya residents were extremely enjoying their town compared to 32.9% among Bal’ma residents (P < 0.001). In addition, residents of Al-Hashimeya were at several folds higher risk to have phlegm and about 3 times more likely to have skin problems compared to participants from Bal’ma (P < 0.001). Furthermore, reporting asthma was substantially higher among Al-Hashimeya residents (odds ratio [OR] = 5.20; 95% confidence interval [CI]: 2.11-12.84), and they were more likely to perceive the neighboring oil refinery industry as the leading cause of their health problems than Bal’ma residents (OR = 86.40; 95%CI: 45.95-162.44).

CONCLUSION: Residents living close to the oil refinery industry in Jordan report adverse impacts on their health, including respiratory problems, skin diseases, and perception of poor health.

This study focuses on the evaluation of the green procurement practices among 7 mining hospitals in Ghana via qualitative analysis techniques. Thus, in this study, based on a 5-year case study, the practices of procurement officers in 7 hospitals belonging to mining companies in Ghana are explored. Within this period, interviews were conducted with key persons with recognizable responsibilities within the supply chain and procurement setup of the facilities. Details of their procurement practices, procedures, and policies were analyzed. A qualitative approach to organizational learning and practice is used to appreciate the existence of these differences observed and also to give a meaning to new perspectives on the challenges in establishing green procurement in the 7 mining companies’ hospitals. The results of the analysis demonstrated that adjustments in the buyers’ practices are not as much dependent on whether they understand, for instance, policies, tools, and procedures, but rather a matter of whether the buyers actually put their knowledge into practice.

Pesticides are used globally in agriculture and pose a threat to the health of farmers, communities, and the environment. Smallholder farmers in low- and middle-income countries have generally a low socio-economic status and educational level. Consequently, they are particularly vulnerable to negative impacts of pesticides on their health, yields, or land. In a Knowledge, Attitude, and Practices study, we compared the pest management practices between a market-oriented farming system in Zarcero County, Costa Rica, and a subsistence-based farming system in Wakiso District, Uganda. We conducted a cross-sectional survey among smallholder farmers from Costa Rica (n = 300) in 2016 and from Uganda (n = 302) in 2017. We enrolled conventional and organic farmers, but also farmers with mixed practices and non-applicators of any pest management strategy. We found that the majority of pesticides used in both case studies are classified as highly hazardous by the World Health Organization. While more than 90% of smallholder farmers from both countries were aware of the negative health effects of pesticide exposure, <11% in Costa Rica and <2% in Uganda reported using personal protective equipment every time they handled or applied pesticides. Hygiene and other safe use practices were not adopted by all farmers (<61%), especially among farmers applying more hazardous pesticides. Conventional farmers from Costa Rica (14%) and Uganda (19%) reported disposing pesticide residuals into rivers. Using a logistic regression we found that organic farmers were more likely to having been trained on safe pesticide use practices. Using a robust regression, we observed that smallholder household income was primarily driven by education and not directly by the use of synthetic pesticides. Our results suggest that negative effects of pesticides can be managed over the whole life cycle, from purchase, via storage and application to residual and waste management by fostering professionalization of farmers. We advise future safe use and handling interventions to consider the pesticide use-related socioeconomic and demographic findings highlighted in this paper.

This community-based cross-sectional study was conducted to investigate the indoor concentration of carbon monoxide (CO) and associated factors in residential buildings of Gondar town, northwest Ethiopia. Data were collected from 384 occupied buildings and occupants using CO meter, interviewers administered questionnaire, and observation checklists. Multivariable binary logistic regression analysis was used for controlling the possible effect of confounders and to identify factors associated with indoor concentration of CO on the basis of adjusted odds ratio (AOR) with 95% confidence interval (CI) and P < .05. The current study revealed that 224(58.3%) occupied buildings had the concentration of CO above the permissible value for 15 minute exposure for living rooms (100 mg/m³). Indoor concentration of CO was significantly associated with access to health information [AOR = 0.081, 95%CI = (0.008, 0.803)], number of rooms [AOR = 0.016, 95% CI = (0.001, 0.279)], area of occupied room [AOR = 0.019, 95% CI = (0.001, 0.237)], buildings located away from main roads/garages [AOR = 0.045, 95% CI = (0.005, 0.415)], clean energy sources [AOR = 0.010, 95% CI = (0.001, 0.123)], presence of separate kitchen [AOR = 0.030, 95% CI = (0.004, 0.221)], no incensing in the room [AOR = 0.055, 95% CI = (0.006,0.499)] and measurements in the afternoon [AOR = 0.114, 95% CI = (0.013, 0.965)]. Residents, therefore, need to use clean energy sources, construct a kitchen with a properly constructed chimneys away from the main building, and avoid incensing inside the indoor environment.

INTRODUCTION: The expansions of labor-intensive investments in a developing countries, especially in textile production create a dusty work environment for workers, and those workers are from the low socio-economic group and need special safety concern.

OBJECTIVE: This study was aimed at assessing the prevalence of respiratory symptoms and associated factors among textile factories workers in Bahir Dar, Amhara region, Ethiopia, 2015.

METHODS: Institutional based cross-sectional study design was employed among randomly selected 384 textile workers using pre-tested interviewer-administered questionnaire. We stratified workers by their working section in the textile industries. Then the proportional numbers of workers were selected from each working section of the factory by using a random number generator. The identification number of workers from each factory was used for selection. The data were checked, coded, and entered to Epi-info Version 7 and exported to the Statistical Package for Social Science Version 20 for further analysis. Both bivariate and multivariate logistic regressions were used to identify associated factors. Variables having a P ⩽ .2 were fitted to multivariate logistic regression so as to assess the presence and strength of association with the respiratory symptom. Variables having a P < .05 were considered as significant.

RESULTS: Three hundred eighty-three (99.74%) of the study participants responded completely filling the questionnaire. In this study, the prevalence of cough, phlegm, bronchitis, chronic bronchitis, and chest pain among the respondents were 31 (8.1%), 45 (11.7%), 26 (6.8%), 2 (0.5%), and 21 (5.5%), respectively. Generally, 141 (36.81%) of the respondents have either of the above respiratory symptoms in the textile industry. Working in the spinning section (AOR = 3.26, 95% CI: 1.80, 5.89), being in the grade 11 and 12 level and below (AOR = 2.36, 95% CI: 1.50, 3.70) and personal protective equipment (PPE) utilization (AOR = 4.88 95% CI: 1.54-15.45) were significantly associated with respiratory symptoms in the multivariate analysis.

CONCLUSION: The prevalence of respiratory symptoms in Bahir Dar Textile workers was relatively high. Working department, educational status, and PPE use were variables significantly associated with respiratory symptoms in this study. Experience sharing across departments, employing educated workers and provision of personal protective equipment are important tasks to be followed to reduce respiratory symptoms in the industry.

Effectively addressing urban health challenges requires engagement of citizens. However, citizens often face barriers providing feedback, and city officials likewise face difficulties incorporating feedback in a meaningful and systematic way. This paper shares one innovative approach to capturing citizens’ stories about urban health concerns, developed by the Building Healthy Cities (BHC) project in 2 Asian cities (Indore, India, and Makassar, Indonesia).

Using ethnographic methods, BHC developed “journey maps” as a monitoring tool to follow key service issues over time. Several urban health-related issues were identified in each city. For this paper, we focus on wastewater management, which was a serious health issue in both cities. Qualitative data were collected from citizens in one neighborhood and city officials quarterly starting in early 2018; these data were supplemented by city spending data, usage statistics, photos and news articles. In both cities, the journey maps captured notable changes during the first 2 years of the project. At the start of the journeys (2018), informal settlement citizens in Indore reported poor drainage which was compounded by trash, narrow roads blocking vehicular removal of waste, and unsafe infrastructure leading to waterborne diseases and injuries (including several child deaths). Likewise in Makassar, dirty water overflowed from open drains due to frequent flooding and garbage. Citizens reported exposure to diarrhea, dengue and skin symptoms due to the drains, which was confirmed by the local health post. By the end of Year 2 (2019), these journeys captured increasing dialogue between citizens and the city, which resulted in several improvements. In Indore, changes included garbage vans built for narrow streets and construction of a safer bridge. In Makassar, while they still suffer from seasonal flooding, the city has increased garbage pickup, included drainage activities in the village-level budgeting process, and a slum improvement project has pledged funding to improve drainage and street issues in 41 neighborhoods. Journey maps work on the premise that capturing a community’s experience and relaying it to government officials can bring about positive change. They also provide crucial grassroots level evidence to support more traditional research findings, which can lead to effective urban health solutions. As this work continues, BHC is training citizens to collect and share their own journeys.

Perennial indoor environmental pollution in the textile industrial area is a potential health hazard for workers engaged in this line of work, resulting in mental aberration to severe health risks. This study was designed to investigate the indoor environmental quality of textile industries and correlate its effect on the occupational health and well-being of the textile workers by measuring plasma oxidative stress status in textile workers and healthy control subjects. Environmental samples were collected from 15 textile industries located in Dhaka division, and 30 volunteer textile workers and 30 volunteer office workers (control) aged 18 to 57 years participated in the study. The concentration of plasma ascorbic acid (P-ASC), plasma malondialdehyde (P-MDA), and plasma conjugated diene (P-CD) was measured in both groups. The noise level (78.0 ± 0.68 dB) and the formaldehyde level (141.80 ± 4.47 µg/m³) were found to be significantly higher in the indoor environmental area compared with those in the control area (70.17 ± 0.25 dB and 108.0 ± 0.76 µg/m³, respectively). Furthermore, the daily average concentration of suspended particulate matters (PMs), that is, PM_2.5 (322.2 ± 13.46 µg/m³) and PM₁₀ (411.0 ± 17.57 µg/m³), was also found to be significantly higher in the indoor environmental air compared with that in the control area (78.59 ± 1.66 and 174.0 ± 2.33 µg/m³, respectively). The levels of P-MDA (0.37 ± 0.03 nmol/L) and P-CD (14.74 ± 0.61 nmol/L) were significantly increased, whereas the level of P-ASC level (0.46 ± 0.04 mg/dL) was markedly decreased in the textile workers compared with the healthy control subjects (0.18 ± 0.01 nmol/L of P-MDA, 10.04 ± 0.44 nmol/L of P-CD, and 1.29 ± 0.06 mg/dL of P-ASC). The textile plants were found to have significantly elevated levels of indoor environmental pollutants compared with those in the control area, and the textile workers were significantly exposed to oxidative stresses compared with the control subjects. The use of noise pads and high-efficiency air filters is perhaps highly instrumental to put an end to this prevailing situation. Moreover, to overcome the oxidative stresses among workers, supplementation of antioxidant vitamins (ie, ascorbic acid and/or vitamin E) may be beneficial. In addition, to prevent serious health-related issues, proper precautions should be taken to protect the occupational health of the textile workers.

BACKGROUND: Zoonoses are an increasing concern worldwide, particularly in low- and middle-income countries. People with close contact with animals are at high risk for contracting and transmitting the zoonotic diseases.

OBJECTIVES: To determine health literacy of livestock farmers toward biosecurity to prevent zoonotic diseases.

METHODS: This cross-sectional mixed-methods study was conducted in Thai Nguyen Province, Vietnam, where livestock and farming are the main occupation. The questionnaire survey was submitted to 218 farmers who have close contact with livestock. In addition, 8 farmers were invited to an in-depth interview to further explore the health literacy.

RESULTS: Half of the participants were men. The average age (standard deviation) of the participants was 49.3(11.5) years. The median years with experience in farming was 15 years. The majority (82.0%) of the participants had moderate health literacy level regarding zoonoses. Improper use of antibiotics was referred by 58.0% of participants, including antibiotic use as feeding supplements (34.0%) and the use of human antibiotics to treat sick animals (24.0%). Many participants were unaware of zoonotic prevention measures and due to this had practices such as not wearing protective equipment (60.0%), an absence of acaricides to prevent vector infestations (52.0%), an absence of disinfection measures (42.0%), low rate of rabies vaccination (54.0%), and do not quarantining sick animals (38.0%). In-depth interviews revealed great concern among farmers about a collective lack of participation from local veterinarians, health workers, and government authorities in zoonoses-prevention efforts. Statistical models showed that farm scale, ethnic groups, and perceived income were associated with the overall health literacy about zoonoses.

CONCLUSION: Comprehensive health education related to zoonotic diseases is recommended to improve overall knowledge, including routes of transmission, symptoms and consequences of diseases, and antibiotic usage. In addition, guidance should be provided to farmers on how to treat sick animals, the appropriate use of antibiotics, and waste management. Local veterinarians and health workers are important contact points and should work closely with the farmers to prevent zoonotic diseases.

In Ghana, environmental hygiene remains a major problem and infection control measures are hardly practised, particularly outside of the hospital. To provide evidence for infection control measures at public places of convenience in Accra (capital city of Ghana), this study was performed. The aim of the study was to evaluate microbial contamination of door handles at public places of convenience in Accra and assess the public health risk. A total of 183 swab specimens were collected aseptically from door handles of public places of convenience of shops, schools, hospitals, lorry stations, churches, and markets. The samples were cultured on bacteriological media, and the isolated organisms were identified. The most prevalent bacterial agent isolated was Bacillus spp. (55.7%), followed by Staphylococcus aureus (20.2%), coagulase-negative staphylococcus spp. (17.1%), Citrobacter freundii (6.0%), Citrobacter koseri (4.4%), and Salmonella Paratyphi A (3.8%). Although in low prevalence, a wide range of enteric bacteria were isolated from door handles, accounting for 12 of the 16 isolated organisms. In conclusion, door handles of places of convenience in Accra harbour several pathogenic microorganisms, especially enteric organisms. This study highlights the need for proper disinfection of door handles of places of convenience in Accra as well as handwashing after visiting such places.

BACKGROUND: Ice is used in large quantities as refreshment in alcoholic and nonalcoholic beverages, especially in summer time. Contamination of edible ice products with pathogens is a public health concern in various countries, including Vietnam. This study aimed to assess the food safety conditions, the quality of edible ice products and related factors at manufacturing premises in Binh Phuoc Province, Vietnam in 2019.

METHODS: A cross-sectional study was conducted in 2019 using both quantitative and qualitative methods. Food safety assessment was carried out in all 45 ice producing premises in the province and 79 ice samples were collected and analyzed microbiologically. In-depth interviews were conducted with 2 food safety management staff, 4 owners of premises, and 4 workers.

RESULTS: Only 22.4% (18/79) and 37.8% (30/79) of the premises met requirement for food safety conditions and microbiological food safety requirements, respectively. Half of the ice samples, 51.9% (41/79), were contaminated, 49.4% (39/79) with Escherichia coli and 12.7% (10/79) with total coliforms. Streptococci, Pseudomonas aeruginosa were not detected. The major risks were material, odds ratio (OR) = 4.2 (95% confidence interval [CI]: 1.002-17.6), structural challenges in the facilities, OR = 4.3 (95% CI: 1.13-16.7), broken floors or difficulty in cleaning, OR = 5.4 (95% CI: 1.26-22.9), and poor staff hygiene practices, OR = 19.5 (95% CI: 4.2-91.1). Workers lacked knowledge and appropriate practices to prevent microbial contamination of ice products.

CONCLUSIONS: The food safety conditions and the quality of ice cubes at manufacturing premises in Binh Phuoc Province were not acceptable. Hygiene deficiencies in ice producing and handling processes, inadequate knowledge of staff, inadequate food safety management practices, and hygiene conditions of the premises were important factors in producing contaminated ice products. We recommend more staff training and crediting the staff when performing adequate practices, paying attention to broken floors or difficulty in cleaning, structural deficiency, and ensuring regular monitoring of premises. This study adds a special interest to ensure food safety conditions at ice producing premises to prevent microbial contamination of the products.

INTRODUCTION: Vietnam is among the countries with the highest smoking prevalence among male adults, as well as high prevalence of secondhand smoke exposure at indoor places. In many countries, including Vietnam, exposure to tobacco smoking is greatest in restaurants/bars and hotels. This study aims to analyze the compliance of hotels and restaurants to smoke-free environment regulations before and after an intervention.

METHODS: Direct observations were done at the receptions, conference rooms, designated smoking areas, restaurants, and lobbies of 140 hotels and the dining rooms, kitchens, and toilets of 160 restaurants before and after an intervention. The intervention was a training course conducted by police officers followed by 3 monthly supervision visits by police officers. Compliance with smoke-free enviornment regulations was observed and assessed to generate a compliance score for each location and overall. Tobit regression was used to examine the relationship between compliance scores and the intervention and other variables such as hotel and restaurant characteristics.

RESULTS: Before the intervention, the highest compliance rates were found for “no tobacco advertisement” and “no cigarette selling” regulations (95%-100%) in almost all sites in hotels and restaurants. The lowest compliance rates were found for “having nonsmoking signs.” The rate of compliance with all regulations was only 5% for hotels and 0.06% of restaurants. Improvement after intervention was clearly observed, in the rate of compliance with all regulations by more hotels (15.7%) and overall compliance scores of hotels and restaurants.

CONCLUSIONS: The intervention with participation of the police officers proved to be effective in improving compliance with smoke-free regulations. It is recommended to continue this intervention in the same areas as well as to expand the intervention to other areas.

BACKGROUND: The Global Climate Risk Index 2020 ranked Vietnam as the sixth country in the world most affected by climate variability and extreme weather events over the period 1999-2018. Sea level rise and extreme weather events are projected to be more severe in coming decades, which, without additional action, will increase the number of people at risk of climate-sensitive diseases, challenging the health system. This article summaries the results of a health vulnerability and adaptation (V&A) assessment conducted in Vietnam as evidences for development of the National Climate Change Health Adaptation Plan to 2030.

METHODS: The assessment followed the first 4 steps outlined in the World Health Organization’s Guidelines in conducting “Vulnerability and Adaptation Assessments.” A framework and list of indicators were developed for semi-quantitative assessment for the period 2013 to 2017. Three sets of indicators were selected to assess the level of (1) exposure to climate change and extreme weather events, (2) health sensitivity, and (3) adaptation capacity. The indicators were rated and analyzed using a scoring system from 1 to 5.

RESULTS: The results showed that climate-sensitive diseases were common, including dengue fever, diarrheal, influenza, etc, with large burdens of disease that are projected to increase. From 2013 to 2017, the level of “exposure” to climate change–related hazards of the health sector was “high” to “very high,” with an average score from 3.5 to 4.4 (out of 5.0). For “health sensitivity,” the scores decreased from 3.8 in 2013 to 3.5 in 2017, making the overall rating as “high.” For “adaptive capacity,” the scores were from 4.0 to 4.1, which meant adaptive capacity was “very low.” The overall V&A rating in 2013 was “very high risk” (score 4.1) and “high risk” with scores of 3.8 in 2014 and 3.7 in 2015 to 2017.

CONCLUSIONS: Adaptation actions of the health sector are urgently needed to reduce the vulnerability to climate change in coming decades. Eight adaptation solutions, among recommendations of V&A assessment, were adopted in the National Health Climate Change Adaptation Plan.

BACKGROUND: Gastrointestinal (GI) symptoms such as abdominal discomfort, abdominal cramp, nausea, vomiting, gas in the GI tract, changes in bowel habits (e.g. diarrhea), or heartburn are common in the community. However, these symptoms may be misinterpreted and their impact and significance misunderstood, especially in the rural communities. This study was, therefore, conducted to assess common GI symptoms among children in rural Dembiya, northwest Ethiopia.

METHODS: A community-based cross-sectional study was conducted in May 2017 among 225 randomly selected under-5 children. We primarily used mothers’ report to assess GI symptoms. Health professionals also diagnosed for some symptoms. Direct stool examination technique was used to identify parasitic infections. Bacteriological analysis of drinking water was done to determine the quality of drinking water. Food safety, environmental sanitation, and hygiene condition of children were assessed using observation checklists. Multivariable binary logistic regression analysis was employed to identify factors associated with GI symptoms on the basis of adjusted odds ratio (OR) with 95% confidence interval (CI) and P < .05.

RESULTS: The current study depicted that 139 of 225(61.8%) of the children had GI symptoms. Abdominal discomfort (137 of 139 [98.7%]), abdominal cramp (125 of 139 [89.9%]), and diarrhea (118 of 139 [84.9%]) were the highest GI symptoms reported. GI symptoms were significantly associated with childhood intestinal parasitic infections (OR = 13.69, 95% CI = 3.31-56.59), unclipped and unclean finger nails (OR = 2.28, 95% CI = 1.02-5.10), inadequate living environment sanitation (OR = 2.37, 95% CI = 1.08-5.18), unclean living houses (OR = 9.06, 95% CI = 2.60-31.54), and owning livestock (OR = 4.68, 95% CI = 1.82, 12.03).

CONCLUSION: The prevalence of GI symptoms among under-5 children in rural Dembiya, northwest Ethiopia, was found to be high. GI symptoms were significantly associated with childhood intestinal parasitic infections, hand hygiene condition of children, and sanitation condition of the living environment. Therefore, preventing intestinal parasitic infections, improving hand hygiene condition, and promoting environmental sanitation will have overriding contributions to prevent symptoms among children in rural Dembiya.

BACKGROUND: Malaria among pregnant women contributes to maternal anemia, low birth weight, spontaneous abortion, and infant deaths. In response to this serious health problem, regular use of the long-lasting insecticidal net is the most cost-effective method of preventing malaria. However, in most developing countries, including Ethiopia, long-lasting insecticidal net utilization by pregnant women is uncertain.

OBJECTIVES: This study was conducted to measure the utilization of insecticidal net and to identify the associated factors with its utilization among pregnant women in Asgede Tsimbla district in 2017.

METHODS: A community-based cross-sectional study was employed and data were collected using interviewer-administered questionnaire. Systematic random sampling method was used to select 550 pregnant women. Data were entered into a computer using Epi Info (version 7) and exported to Statistical Package for the Social Sciences (version 21) for further analysis. Variables with P-value less than 0.05 were used to declare statistical significance between the dependent and the independent variables in multivariable logistic regression.

RESULTS: Among 550 pregnant women surveyed, 347 (63.1%) of the pregnant women slept under a long-lasting insecticidal net the night before the survey. Urban residence (OR [95% CI] = 1.9 [1.22-3.01]), family size of 3-5 and >5 (2.8 [1.53-5.22] and 2.4 [1.20-5.03], respectively), and history of malaria during their current pregnancy (3.0 [1.95-4.86]) were found to be the factors associated with pregnant women’s long-lasting insecticidal net utilization.

CONCLUSION: Utilization of long-lasting insecticidal net was low, and place of residence, exposure status to malaria during their current pregnancy, and family size were the factors associated with long-lasting insecticidal net utilization.

The present study was conducted to determine daily intake of cadmium (Cd), copper (Cu), and lead (Pb) and to assess noncarcinogenic human health risk caused by these trace metals in the commonly consumed fish species (Oreochromis niloticus, Rastrineobola argentea, Lates niloticus, and Protopterus aethiopicus) in Nakuru town, Kenya. Trace metal determination in the composite samples of the commonly consumed fish species was done using flame atomic absorption spectrophotometer. Cd, Cu, and Pb content in the muscle tissues of the commonly consumed fish species ranged from 0.11 ± 0.045 to 1.11 ± 0.931 mg kg⁻¹ for Cd, 0.48 ± 0.013 to 3.00 ± 0.009 mg kg⁻¹ for Cu, and 3.42 ± 0.045 to 12.78 ± 0.108 mg kg⁻¹ for Pb. Cu concentrations were within Food and Agriculture Organization (FAO) recommended limits for this trace metal in fish. In contrast, Cd and Pb had values above their respective permissible limits in fish. The assessment of human exposure to trace metals indicated that exposure doses of Cd and Cu were safe for fish consumers. Conversely, target hazard quotient (THQ) values of Pb suggested possible health risks for consumers of the commonly consumed fish species in Nakuru town, Kenya.

Cities in the United States have announced initiatives to become more sustainable, healthy, resilient, livable, and environmentally friendly. However, indicators for measuring all outcomes related to these targets and the synergies between them have not been well defined or studied. One such relationship is the linkage between air quality with emotional well-being (EWB) and neighborhood infrastructure. Here, regulatory monitoring, low-cost sensors (LCSs), and air quality modeling were combined to assess exposures to PM_2.5 and traffic-related NO_x in 6 Minneapolis, MN, neighborhoods of varying infrastructure parameters (median household income, urban vs suburban, and access to light rail). Residents of the study neighborhoods concurrently took real-time EWB assessments using a smart phone application, Daynamica, to gauge happiness, tiredness, stress, sadness, and pain. Both LCS PM_2.5 observations and mobile-source-simulated NO_x were calibrated using regulatory observations in Minneapolis. No statistically significant (α = 0.05) PM_2.5 differences were found between urban poor and urban middle-income neighborhoods, but average mobile-source NO_x was statistically significantly (α = 0.05) higher in the 4 urban neighborhoods than in the 2 suburban neighborhoods. Close proximity to light rail had no observable impact on average observed PM_2.5 or simulated mobile-source NO_x. Home-based exposure assessments found that PM_2.5 was negatively correlated with positive emotions such as happiness and to net affect (the sum of positive and negative emotion scores) and positively correlated (ie, a higher PM_2.5 concentration led to higher scores) for negative emotions such as tiredness, stress, sadness, and pain. Simulated mobile-source NO_x, assessed from both home-based exposures and in situ exposures, had a near-zero relationship with all EWB indicators. This was attributed to low NO_x levels throughout the study neighborhoods and at locations were the EWB-assessed activities took place, both owing to low on-road mobile-source NO_x impacts. Although none of the air quality and EWB responses were determined to be statistically significant (α = 0.05), due in part to the relatively small sample size, the results are suggestive of linkages between air quality and a variety of EWB outcomes.

Mitigation of risk for Shiga toxin-producing Escherichia coli (STEC) and Salmonella contamination was evaluated after a multiple-intervention approach (comprising food safety education and training, implementation of customized food safety practices and programs, and environmental monitoring programs with audits and corrective actions) in 2 small Honduran beef abattoirs. Previously, neither abattoir had food safety programs in place nor were they subjected to strict food safety regulatory surveillance. Abattoirs A and B were sampled on 4 nonconsecutive months each. Swab samples of abattoir A (n = 160, 40 samples per sampling date) and abattoir B (n = 78, 16-22 samples per sampling date) were taken from direct and indirect food contact surfaces, screened by BAX real-time polymerase chain reaction (PCR) assays and confirmed using immunomagnetic separation, selective media, and latex agglutination. In abattoir A, Salmonella presence was negligible, whereas presumptive STECs were present in 10%, 12.5%, 0%, and 5% of the environmental samples respective to each sampling month, indicating a reduction of STEC (P = .06) by the third and fourth sampling months. Conversely, presumptive STEC presence was negligible in abattoir B, whereas Salmonella presence for each sampling month was of 5.6%, 6.3%, 27.3%, and 0.0%, respectively. Upon the increased pathogen presence detected on the third sampling month, additional actions were taken to reinforce the implementation of food safety practices and programs, which resulted in a Salmonella reduction to 0% by the fourth sampling month (P = .013). The satisfactory results strongly suggest that a multiple-intervention approach is crucial to improve food safety in this type of premises.

INTRODUCTION: Despite advancements in food science and technology, foodborne disease remains one of the major public health problems. Poor sanitation and hygiene conditions of food establishments are the major causes for the occurrence of foodborne disease. Therefore, this study aimed to investigate core determinants of sanitation and hygiene status among food establishments.

METHODS: Institution-based cross-sectional study design was conducted in Addis Ababa city. A stratified random sampling technique was deployed to select 413 study participants. Data were collected through interview and using observational checklist. Sample size was determined by using a single population proportion formula. To analyze the data, binary logistic regression and multivariable logistic regression analysis was conducted. In all analysis, P-value less than .05 were considered statistically significant.

RESULTS: The study revealed that 57.4% of the food establishments were under poor sanitation status. In the multivariable analysis, presence of trained managers on hygiene and sanitation (adjusted odds ratio [AOR] = 6.10 with 95% confidence interval [CI]: 2.41-15.45), presence of renewed licenses (AOR = 3.07 with 95% CI: 1.18-7.99), absence of bureaucratic function to obtain permission to renew the food establishment buildings (AOR = 2.43 with 95% CI: 1.25-4.70), and presence of at least 10-m distance between toilet and kitchen (AOR = 9.19, at 95% CI: 5.63-15.02) were associated significantly with sanitation and hygiene status.

CONCLUSIONS: Above average of the food establishments were found to be in poor sanitation and hygiene state. Many core determinant factors that influence sanitation and hygienic status of food establishments were identified. The researchers suggest that formal training on sanitation and hygiene for managers of food establishments should be provided to reduce the occurrence of foodborne diseases. Moreover, strong food and water safety policy and strategy should be promulgated to improve sanitation and hygiene status of food establishments.

Arsenic is a public health concern because of its widespread distribution and high toxicity, even when doses are small. Low birth weight (LBW) occurrence, birth weights less than 2500 g, may be associated with prenatal exposure of arsenic from environmental factors and consuming contaminated drinking water and food. The objective of this study was to examine whether mothers living in areas of Escambia and Santa Rosa counties with varying levels of background arsenic in surface soil and water were associated with the occurrence of LBW. Inverse distance weight in ArcGIS was used to interpolate arsenic concentrations from environmental samples and estimate arsenic concentrations by census tracts in the two counties. After excluding multiple births and displaced geocoding addresses, birth data were obtained for the years of 2005 (n = 5845), 2010 (n = 5569), and 2015 (n = 5770) from the Bureau of Vital Statistics at the Florida Department of Health to assess temporal differences. Generalized linear models were used to analyze and compare the association between child and maternal demographic information, socioeconomic characteristics, and the environmental estimates of arsenic with LBW. No significant association was found between environmental arsenic concentration and LBW, suggesting that environmental contamination of the pregnant mother’s census tract may not be a useful proxy in assessing risk for LBW.

BACKGROUND: The 21st century has seen a wide range of diseases resulting from zoonotic infections, of which bacterial infections have led to outbreaks of food-borne diseases.

AIM: The study looks at bacterial pathogen carriage by farm rats and their antimicrobial susceptibility, with the view of providing insights for antimicrobial surveillance.

METHOD: Farm rats of Rattus rattus species where randomly collected alive from farms in Al-Ahsa using food baits. They were anaesthetize with urethane within 4 h of collection and were unconscious for the collection of samples. Basic bacteriological culturing methods were used for culturing of bacterial isolates on selective media while the Vitek 2 compact automated system (BioMerieux, Marcy L’Etoile, France) was used for bacteria identification and antimicrobial susceptibility test. Obtained data were analysed using chi-square and paired t-test with significant difference between sensitive and resistance to antimicrobial susceptibility taken at P < .05.

RESULTS: Isolated Gramme-negative pathogenic bacteria included strains of Escherichia coli, Pseudomonas oryzihabitans, strains of Pseudomonas aeruginosa, and Salmonella. For the Gramme-positive bacteria, 4 strains of Staphylococcus aureus were encountered. Other Gramme-positive bacteria were coagulase-negative Staphylococcal species (CoNS) as well as Staphylococcus lugdunensis. There was a 100% resistance to the penicillins and a high resistance to imipenem (71%) by the Staphylococcal isolates. Resistance was also high against the β-lactams by the Gramme-positive bacteria isolates. For the Gramme-negative bacteria, there was a higher than 50% resistance by the isolates against the following antibiotics: ampicillin (78%), amoxicillin/clavulanic acid (67%), cefotaxime (77%), ceftazidime (67%), cefepime (78%), norfloxacin (67%), nitrofurantoin (67%), and trimethoprim/sulfamethoxazole (78%).

CONCLUSION: The results showed high antimicrobial resistance that will need monitoring for control of spread from farm rats to humans.

Health problems can arise from consuming contaminated well water. Well water testing can help prevent negative health outcomes associated with consuming contaminated water. The aim of this study was to understand the factors influencing well owner decisions to conduct water testing through the theoretical lens of the Health Belief Model. We conducted semi-structured interviews with 20 well owners and used framework analysis to sort and analyse the data. The results demonstrated that well owners’ perceived susceptibility to well water contamination was low, while the perceived severity of contamination, benefits of testing, and self-efficacy towards testing were high. Cues to action to promote testing focused on increasing well owner education and awareness through well stewardship programmes and reminders to test. Participants faced some barriers to water testing. Increasing education and awareness about well water contamination and water testing, while reducing logistical barriers to testing, may improve compliance with water testing.

Volatile organic compounds (VOCs) are emitted from a variety of household and personal care products. Many VOCs are known to be potentially toxic or carcinogenic. Synthetic hair is used in hair-styling practices, including practices in African American communities that involve singeing or heating the synthetic hair. The research questions that we sought to answer were as follows: Are VOCs emitted from singed or heated synthetic hair? If so, what are the VOC species and relative masses identified in singed or heated synthetic hair? We tested samples from 2 sources of singed and heated synthetic hair in a microchamber; one source was flame-retardant synthetic hair and the other source was non-flame-retardant synthetic hair. Our findings confirmed that VOCs are emitted from singed or heated synthetic hair for both types of sources. For flame-retardant synthetic hair, we identified and measured mass for species that included acetone, acetonitrile, 2-butanone, benzene, chloromethane, chloroethane, and 1,2-dichloroethane. For non-flame-retardant synthetic hair, we identified and measured mass for species that included acetone, acetonitrile, chloromethane, trichlorofluoromethane, and 2-propanol.

Monitoring and understanding the trend and dynamics of insecticide resistance is very key to devising efficient control strategies. This study was carried out to characterize the mosquito population, its insecticide resistance profile, and the physicochemical properties of their breeding sites in Sharada and Wailari of Kano State, Nigeria. Six breeding sites from the 2 study areas were sampled and their physicochemical parameters determined. Mosquito larvae were sampled from the sites and reared to adult. The emergent adults were morphologically and molecularly identified to species level. The World Health Organization (WHO) susceptibility assay was carried out on the adult mosquitoes using different classes of insecticides in WHO discriminating concentrations. kdr-mutation was detected by polymerase chain reaction (PCR)-based method using the permethrin (pyrethroid) resistant and susceptible adult mosquitoes. Most of the determined physicochemical parameters were significantly higher in the industrial area, Sharada. Morphologically, the mosquitoes from the 2 sites were identified as Anopheles gambiae and 100% of the randomly sampled population were found to be Anopheles coluzzii by PCR-based molecular technique. The WHO susceptible assay revealed a graded level of resistance to bendiocarb, dichlorodiphenyltrichloroethane (DDT), and permethrin with mortalities of 78.36%, 75.74%; 43.44%, 56.96%; and 37.50%, 37.50% in both Sharada and Wailari, respectively. Pre-exposure to piperonyl butoxide (PBO) resulted in a significant but minor recovery of susceptibility to permethrin. The kdr mutation frequency was higher in Sharada (45.71%) relative to Wailari (31.43%). Higher kdr mutation frequency was also observed in the resistant population (48.56%) relative to the susceptible (28.54%). The kdr mutation frequency was weakly associated with the resistance status (odds ratio [OR]: 5.9, χ²:3.58, P = .058) and the breeding sites (OR: 3.46, χ²:2.90, P = .088). In conclusion, the study revealed a highly pyrethroid-resistant A coluzzii population with low PBO recovery rate. Furthermore, the data suggested the involvement of kdr mutation, detoxification enzyme, and possibly abiotic factors of the breeding sites.

Food-borne disease is a widespread and escalating public health problem globally. About a quarter of the microorganisms isolated from cockroaches are food-borne pathogens including Escherichia coli O157:H7, Staphylococcus aureus, Bacillus cereus, Shigella dysenteriae, Salmonella enterica subsp. enterica serovar Typhi, Rotavirus, Aspergillus fumigatus, and Cryptosporidium parvum. Thus, cockroaches could be an important reservoir and mechanical vector of food-borne pathogens. Generally, the role of cockroaches in human infections is poorly understood and has been an issue of debate for several years. This article aims to elucidate the possible role of cockroaches in food-borne infections by reviewing the relevant research publications.

Air pollution is a growing public health concern in developing countries and poses a huge epidemiological burden. Despite the growing awareness of ill effects of air pollution, the evidence linking air pollution and health effects is sparse. This requires environmental exposure scientist and public health researchers to work more cohesively to generate evidence on health impacts of air pollution in developing countries for policy advocacy. In the Global Environmental and Occupational Health (GEOHealth) Program, we aim to build exposure assessment model to estimate ambient air pollution exposure at a very fine resolution which can be linked with health outcomes leveraging well-phenotyped cohorts which have information on geolocation of households of study participants. We aim to address how air pollution interacts with meteorological and weather parameters and other aspects of the urban environment, occupational classification, and socioeconomic status, to affect cardiometabolic risk factors and disease outcomes. This will help us generate evidence for cardiovascular health impacts of ambient air pollution in India needed for necessary policy advocacy. The other exploratory aims are to explore mediatory role of the epigenetic mechanisms (DNA methylation) and vitamin D exposure in determining the association between air pollution exposure and cardiovascular health outcomes. Other components of the GEOHealth program include building capacity and strengthening the skills of public health researchers in India through variety of training programs and international collaborations. This will help generate research capacity to address environmental and occupational health research questions in India. The expertise that we bring together in GEOHealth hub are public health, clinical epidemiology, environmental exposure science, statistical modeling, and policy advocacy.

BACKGROUND: Drinking water quality affects directly human health. Assessment and prevention of water-borne diseases are crucial for primary prevention, especially for children.

OBJECTIVE: The main aim of this study was to investigate the quality of drinking water from tap water in preschools and primary schools in a district area in Hanoi City, Vietnam.

METHODS: A cross-sectional study was performed from August to October 2019. Water samples from tap water of 154 schools in a district area of Hanoi were collected to determine the quality of drinking water. From each school, at least 2 bottles of water samples were collected on the basis of a standard operating procedure (SOP). Each water sample was analyzed for microbial and physicochemical parameters, including Color, Taste and Odor, Turbidity, pH, Nitrite, Nitrate, Ammonium, Total Iron, Permanganate, Chloride, Hardness, Total Manganese, Sulfate, Arsenic, Coliform, and E.coli, by analytical methods. The obtained values of each parameter were compared with the standard values set by WHO and National Technical Regulation on Domestic Water Quality of Vietnam.

RESULTS: All of the schools employed community water system as a main source for drinking water. The results showed that all tested samples were found to be within the standards for some physicochemical properties, including Color, Taste and Odor, Hardness, Chloride, Total Iron (Fe²⁺ và Fe³⁺), Total Manganese (Mn), Nitrate (NO₃^–), Sulfate (SO₄^2–), and Total Arsenic (As). On the other hand, some samples did not meet the allowable limits of the national standard, due to pH (3.9%), Turbidity (0.6%), Nitrite (3.2%), Permanganate (6.5%), and Ammonium (5.8%). Furthermore, the microbial data revealed that the substandard water samples from municipal water systems were contaminated by Coliform (9.7%) and/or E.coli (7.8%).

CONCLUSIONS AND RECOMMENDATIONS: Contaminants such as bacterial and chemical agents in to drinking water could be occurred during transport, storage and handling before using by the consumer without regular surveillance. A periodic treatment procedure and monitoring system to keep the level of microbial and chemical contamination of drinking water in schools under control should be performed.

BACKGROUND: Contact with livestock wastewater on farms and in communities can pose a risk to human and animal health.

METHODS: This cross-sectional study was conducted in 180 households and 24 pig farms (96 wastewater samples) to explore information about pig production, livestock waste management, antibiotic use, and to analyze antibiotic residues and microbial contamination, respectively.

RESULTS: Of the 120 households raising pigs, biogas systems were the most commonly used to treat animal waste (70%), followed by compositing (19%), and the remaining respondents discharged waste directly into drains or ponds (11%). The majority of respondents (78%) used antibiotics to treat and prevent disease in pigs, but 32% of them did not know of any disadvantages of antibiotic abuse. ELISA assays were performed on half of the wastewater samples (n = 48), demonstrating that residues of flouroquinolones and sulfonamides were present in 6.3% (3/48) and 22.9% (11/48) of tested samples, respectively. The average residual level of sulfamethazine was 27.8 ug/l. Further, E. coli concentrations exceeding regulatory levels in Vietnam were found in nearly all samples. Salmonella spp. was also found in 57.3% of samples, though prevalence rates varied across the different sites. Finally, G. lamblia was found in 8.4% of samples, and C. parvum was found in 5.2% of samples.

CONCLUSIONS: This study suggests that livestock wastewater carried potential harmful pathogens and antibiotic residues that could come into contact with humans in the community. Thus, appropriate operation and application of livestock wastewater treatment (such as biogas or composting) and management should be a continued focused.

BACKGROUND: Achieving access to clean water and basic sanitation remains as major challenges in Vietnam, especially for vulnerable groups such as minority people, despite all the progress made by the Millennium Development Goal number 7.C.

OBJECTIVES: The study aimed to describe the access to improved water sources and sanitation of the ethnic minority people in Vietnam based on a national survey and to identify associated factors.

METHODS: A cross-sectional study was conducted in 2019 with a sample size of 1385 ethnic minority households in 12 provinces in Vietnam. Multivariate logistic regression modeling was performed to examine the probability of having access to improved water sources and sanitation and sociodemographic status at a significance level of P < .05.

RESULTS: The access to improved water sources and sanitation was unequal among the ethnic minority people in Vietnam, with the lowest access rate in the northern midland and mountainous and Central Highland areas and the highest access rate in the Mekong Delta region. Some sociodemographic variables that were likely to increase the ethnic minority people’s access to improved water sources and/or sanitation included older age, female household heads, household heads with high educational levels, religious households, and households in not poor status.

CONCLUSION AND RECOMMENDATIONS: The study suggested more emphasis on religion for improving the ethnic minority’s access to improved water sources and sanitation. Besides, persons of poor and near-poor status and with low educational levels should be of focus in future water and sanitation intervention programs.

BACKGROUND: Vietnam declared its national roadmap towards Sustainable Development Goals number 6 by 2030. However, specific supporting programmes and financial means to proceed with the roadmap have not been passed on. Evidence on the financing for water, sanitation, and hygiene (WASH) being allocated or spent has not been well documented in Vietnam. This study aimed to obtain an overview and assessed the public funding across the WASH sector of Vietnam in 3 fiscal years 2016, 2017, and 2018.

METHODS: A cross-sectional study was conducted for information about the public financing for WASH at both national and sub-national levels. An activity-based costing approach was applied to determine WASH-related public expenditure. Fourteen focus group discussions with key stakeholders were used to identify the WASH activities and to access financial reports of these relevant institutions. TrackFin methodology was used to assemble the public financing for WASH in Vietnam.

RESULTS: The public expenditure of WASH declined by about 30.7% over the 3 fiscal years, from US $2016 million in 2016 to US $1397 million in 2018. Meanwhile, this expenditure allocated to the poor or mountainous areas increased by 3 folds. The highest proportion of WASH public funding was invested in sanitation through large network systems (59.07% of the total public expenditure), whereas the lowest was in hygiene promotion and handwashing facilities. The domestic budget was still the main source of public financing for WASH services, with 2 largest shares coming from government revenues (47.24%) and repayable loans (20.49%).

CONCLUSION: The main source of financing for WASH was from the government, yet its public expenditure has been decreased. A refined roadmap with specific steps for a sustainable WASH financing system in Vietnam, particularly to leverage government and private sector resources, is required to ensure no one is left behind.

BACKGROUND: Heavy metal contamination and related risks for the environment and human health are matters of increasing concern.

METHODS: The levels of 4 heavy metals (Cr, Cd, Pb, and As) were evaluated in 2 water types (surface and well), 4 types of seafood (tiger shrimp, stuffed snail, snake-head fish, and catfish), and 27 types of vegetables (12 leafy vegetables, 4 pea plants, 4 tuber vegetables, and 7 herbs) that are commonly consumed in northern coastal communes located in Vietnam. Atomic absorption spectrometry was employed for quantification.

RESULTS: The mean concentrations of heavy metals detected in water, seafood, and vegetable samples exceeded the national permitted standards and World Health Organization (WHO) recommendation values by at least 2-fold, 2.5-fold, and 5-fold for surface water, vegetables, and well water, respectively. The concentrations of all 4 heavy metals detected in seafood samples were higher than the standards. The levels of heavy metals decreased with increasing distance between the sample collection point and the pollution source.

CONCLUSIONS: This is the first report of heavy metal contamination of common sources of food and water in the northern coastal area of Vietnam. Significantly, the concentrations of heavy metals detected in study samples exceeded the regulatory limits. These results underscore the importance of continued monitoring and the development of intervention measures to ensure that the quality of food and water meets established standards and protects the health of the local population.

Mosquito insecticide resistance (IR) is a growing global issue that must be addressed to protect public health. Vector control programs (VCPs) should regularly monitor local mosquito populations for IR and plan control measures accordingly. In some cases, state/federal resources financially support this testing with expertise and/or training programs. Standardization of methods (eg, Centers for Disease Control and Prevention bottle bioassay, World Health Organization tube testing, dose-mortality bioassay) for monitoring IR must be prioritized. One solution is regional hubs of IR monitoring at the state or other level. Training programs on methodology and interpretation of results should be developed and routinely offered to local VCPs conducting IR testing in mosquitoes. Here, current methods for assessing mosquito IR are discussed and insights into a variety of questions from VCPs are considered. It is critical that methods for IR monitoring and data interpretation are standardized through routine training, with the goal of evidence-driven decision making to improve control of mosquitoes and mosquito-borne disease.

Container Aedes mosquitoes are responsible for the transmission of anthroponotic and zoonotic viruses to people. The surveillance and control of these mosquitoes is an important part of public health protection and prevention of mosquito-borne disease. In this study, we surveyed 327 sites over 2 weeks in late June and early July in 2017 in North Carolina, USA for the presence and abundance of Aedes spp. eggs in an effort to better target potential Ae. aegypti collections. We examined the ability of 2 types of landscape data, Light Detection And Ranging (LIDAR) and National Land Cover Database (NLCD) to explain the presence and abundance of eggs using principal component analysis to deal with collinearity, followed by generalized linear regression. We explained variation of both egg presence and abundance for Aedes albopictus (Skuse) and Aedes triseriatus (Say) using both NLCD and LIDAR data. However, the ability to make robust predictions was limited by variation in the data. Increased sampling time and better landscape data would likely improve the predictive ability of our models, as would a better understanding of oviposition behavior.