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Title: Health and economic burden of human Streptococcus suis infection in Viet Nam and the contribution of undercooked pig product consumption practices : implications for prevention and control
Author: Vu, Huong
ISNI:       0000 0004 6498 925X
Awarding Body: University of Oxford
Current Institution: University of Oxford
Date of Award: 2016
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Streptococcus suis is a zoonotic bacterium capable of causing severe systemic infection in humans, including central nervous system infection (meningitis) which can lead to long-term sequelae including deafness and vestibular dysfunction. Despite a growing body of literature on the epidemiology, microbiology and molecular aspects of the disease, there has been little progress on the prevention and control of this disease in Asia. This thesis aimed to examine the long-term consequences of the disease in patients, quantify the health and economic impact, and investigate the local practice of consuming raw pig blood, one of the main risk factors for S. suis infection in Viet Nam. A systematic review and meta-analysis conducted in this thesis showed that hearing loss and vestibular dysfunction were the most common health sequelae in patients surviving S. suis infection. In a patient follow-up study at a referral hospital in Ha Noi, I found that severe hearing loss and vestibular dysfunction both occurred, and persisted over a long period in 40% of patients. Morbidity caused by these two conditions accounted for about half of the disability adjusted life years lost due to the infection. The analysis of disease impact showed that S. suis infection caused a considerable impact on the patients and their family. The direct cost of hospitalization was estimated to be 35 million VND per episode (~ 1600 USD), which was greater than the average annual per-capita income in Viet Nam. The total annual cost of the disease was 54-70 billion VND (2.5-3.3 million USD), more than 80% of which was attributed to productivity loss due to premature deaths and long-term disability. A mixed-methods community-based study, consisting of both quantitative survey and focus group discussion, showed that raw pig blood consumption was common in Viet Nam (reported in 35% of rural and 8.6% of urban participants). Many misperceptions about food safety and risk of disease transmission existed in the community; most importantly was the belief that apparently healthy or free-ranging pigs did not pose health risks to consumers. Data from this thesis can be used by public health and policy makers to prioritise and justify resource allocation and to identify options for disease prevention and control.
Supervisor: Hoa Thi Ngo ; Wertheim, Heiman F. L. ; Horby, Peter W. Sponsor: Wellcome Trust ; University of Oxford ; NDM Tropical Network Fund
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available