title: Challenges of hemodialysis in Vietnam: experience from the first standardized district dialysis unit in Ho Chi Minh City.
abstract: BACKGROUND
  Hemodialysis is an increasingly common treatment in Vietnam as the diagnosis of end stage renal disease continues to rise. To provide appropriate hemodialysis treatment for end-stage renal disease patients, we conducted a 1-year cross-sectional study to measure the prevalence of bloodborne infection and factors associated with non-compliant behaviors in hemodialysis patients.
  
  
  METHODS
  One hundred forty-two patients were tested for hepatitis B virus (HBV) surface antigen and hepatitis C virus (HCV) core antigen. They provided demographic, medical and dialysis information. Non-compliant behaviors were obtained from their medical records.
  
  
  RESULTS
  Overall, 99 % of patients reused their dialyzers and 46 % had arteriovenous fistula on admission. Both HBV and HCV equally accounted for 8 % of patients and concurrent infection accounted for 1 %. Non-compliance rates of dietary and medication were 39 and 27 % respectively. 42 % of patients missed hemodialysis session, 8 % were verbally or physically abusive and 9 % were non-cooperative. Of the 54 % catheterized patients, 7 % improperly cared for their dialysis access. Dietary non-adherence was associated with male patients (p = 0.03) and medication non-adherence was associated with younger age (p = 0.05). Duration between diagnosis of chronic kidney disease and initiation of hemodialysis was associated with improper care of dialysis access (p = 0.04). Time on hemodialysis was associated with missed hemodialysis session (p = 0.007) and verbal or physical abuse (p = 0.01).
  
  
  CONCLUSIONS
  Health services need to provide safe practice for dialyzer reuse given the endemicity of hepatitis. We believe a national survey similar to ours about seroprevalence and infection control challenges would prepare Vietnam for providing safer satellite treatment units. Safe hemodialysis services should also comprise patient preparedness, education and counseling.
authors.affiliation: School of Public Health and Community Medicine, UNSW Medicine, UNSW Australia, Level 3 Samuels Building, Sydney, 2052, NSW, Australia. minh.duong@student.unsw.edu.au.
authors.forename: Cuong Minh
authors.initials: CM
authors.lastname: Duong
authors.affiliation: Division of Infectious Diseases, University Medicine Cluster, National University Health System, Singapore, Singapore. mdcdpo@nus.edu.sg.
authors.forename: Dariusz Piotr
authors.initials: DP
authors.lastname: Olszyna
authors.affiliation: Training Center for Family Physicians, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam. Nguyenduyphongvn@yahoo.com.
authors.forename: Phong Duy
authors.initials: PD
authors.lastname: Nguyen
authors.affiliation: School of Public Health and Community Medicine, UNSW Medicine, UNSW Australia, Level 3 Samuels Building, Sydney, 2052, NSW, Australia. m.mclaws@unsw.edu.au.
authors.forename: Mary-Louise
authors.initials: ML
authors.lastname: McLaws
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000374:Aggression; D003430:Cross-Sectional Studies; D004032:Diet; D017743:Equipment Reuse; D005260:Female; D006436:Hemodialysis Units, Hospital; D006514:Hepatitis B Surface Antigens / Q000276:immunology; D019694:Hepatitis B, Chronic / Q000453:epidemiology* / Q000276:immunology; D018936:Hepatitis C Antigens / Q000276:immunology; D019698:Hepatitis C, Chronic / Q000453:epidemiology* / Q000276:immunology; D006767:Hospitals, District; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000628:therapy*; D007688:Kidneys, Artificial; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data; D015995:Prevalence; D014505:Urban Population; D014744:Vietnam / Q000453:epidemiology; D014758:Viral Core Proteins / Q000276:immunology; D055815:Young Adult; D016903:Drug Monitoring
chemical_list: D006514:Hepatitis B Surface Antigens; D018936:Hepatitis C Antigens; D014758:Viral Core Proteins