Peer-reviewed article
Ear-nose-throat morbidity patterns and determinants among Vietnamese Highland schoolchildren.
Pham Xuan Tue, Le Thi Kim Dung, Truong Thi Thuy Duong, Pham Trung Kien, Le Thi Thanh Hoa ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001Half of primary school children in mountainous northern Vietnam have ear-nose-throat diseases, most commonly affecting the nose, sinuses, and tonsils. Children who are stunted (too short for their age) and those from certain ethnic groups are more likely to have these conditions. Classrooms with higher levels of bacteria, fungi, and carbon dioxide had more cases of ENT disease, suggesting that poor indoor air quality contributes to the problem.
Key points
- 50.9% of children (422 pupils in Grades 1-5) were diagnosed with at least one ENT condition
- Most common conditions were nose/sinus disease (32.2%) and tonsillitis (30.1%)
- ENT morbidity was significantly higher among stunted children (p = 0.040) and varied significantly by ethnicity (p < 0.001)
- Affected classrooms had higher bacterial loads (817.0 vs. 577.4 CFU/m³), fungal loads (480.0 vs. 371.8 CFU/m³), and CO₂ levels (550.3 vs. 523.5 ppm)
- Age, sex, and BMI-for-age were not significantly associated with ENT morbidity
Limitations
This cross-sectional study cannot determine causation, only association between ENT disease and nutritional or environmental factors. The study was limited to four primary schools in one mountainous region of Vietnam, so findings may not represent other highland or lowland areas.
Abstract
OBJECTIVES: To describe the clinical profile of ear-nose-throat (ENT) diseases among primary school children in mountainous northern Vietnam and to analyze associated demographic, nutritional, and classroom environmental factors. METHODS: A school-based cross-sectional study was conducted in four primary schools in Sa Pa, Lao Cai. A total of 422 pupils in Grades 1-5 with complete data were included. Standardized interviews and clinical ENT examinations were conducted, and anthropometric indices were converted to WHO Z-scores (WAZ, HAZ, BAZ). Classroom environments were evaluated following TCVN 13521:2022, including measurements of temperature, humidity, air velocity, CO₂, particulate matter (PM₂.₅, PM₁₀), and bioaerosols (bacteria, fungi, CFU/m³). Statistical analyses used χ² and t-tests. RESULTS: Half of the children (50.9%) were diagnosed with at least one ENT condition, most commonly nose/sinus disease (32.2%) and tonsillitis (30.1%). ENT morbidity was significantly higher among stunted children (p = 0.040) and varied by ethnicity (p < 0.001), while age, sex, and BMI-for-age were not significant. Affected classrooms had higher bacterial (817.0 vs. 577.4 CFU/m³) and fungal loads (480.0 vs. 371.8 CFU/m³) and elevated CO₂ (550.3 vs. 523.5 ppm), indicating poorer air quality (all p < 0.001). CONCLUSION: ENT diseases are common among highland Vietnamese schoolchildren and are linked to chronic undernutrition and suboptimal indoor air quality. Practical interventions such as improved classroom ventilation, humidity control, and regular school-based ENT screening and nutrition programs are urgently needed to reduce disease burden and enhance child health and learning outcomes.