Oxford University Clinical Research Unit, Hanoi and Ho Chi Minh City, Vietnam.
National Hospital for Tropical Diseases, Hanoi, Vietnam.
Glob Public Health. 2024 Jan;19(1):2403097. doi: 10.1080/17441692.2024.2403097. Epub 2024 Sep 16.
The exact aetiology of the cause of death (COD) remains unknown for a high proportion of deaths caused by infectious diseases. Complete diagnostic autopsy (CDA) is considered the gold standard to determine COD, but it is often not used in low and middle-income countries (LMIC), including Vietnam, for a variety of reasons. One alternative is minimally invasive tissue sampling (MITS). This study was part of a larger project to explore the perceptions of MITS in Vietnam to provide recommendations for its potential implementation. We collected in-depth interviews and focus group discussions that explored MITS acceptability from 96 participants, including key informants, healthcare workers, community stakeholders, and people who had family members pass away recently. Participants highlighted the minimally invasive nature as the most considerable strength of MITS that could make it acceptable in Vietnam compared with CDA. However, participants still had concerns including the accuracy of the technique, the potential damage on the body, and the potential conflicts MITS results could have with original clinical diagnoses. Overall, the hypothetical acceptability of MITS was not clear-cut. It is imperative to consider acceptability before implementing new medical procedures into a given context, especially when it revolves around death, dying and the body.
由于传染病导致的死亡中,有很大一部分其确切病因仍不清楚。彻底的诊断性尸检(CDA)被认为是确定死因(COD)的金标准,但由于各种原因,它在包括越南在内的低收入和中等收入国家(LMIC)并不常用。一种替代方法是微创组织取样(MITS)。本研究是一个更大项目的一部分,旨在探索越南对 MITS 的看法,为其潜在实施提供建议。我们收集了 96 名参与者的深入访谈和焦点小组讨论,这些参与者包括主要知情人、医疗保健工作者、社区利益相关者以及最近有亲人去世的人,探讨了 MITS 的可接受性。参与者强调了 MITS 的微创性质,这是它在越南比 CDA 更具可接受性的最主要优势。然而,参与者仍存在一些担忧,包括该技术的准确性、对身体的潜在损害,以及 MITS 结果可能与原始临床诊断之间的潜在冲突。总的来说,MITS 的假设可接受性并不明确。在将新的医疗程序引入特定环境之前,考虑可接受性至关重要,尤其是在涉及死亡、临终和身体时。