Y HQC VlgT NAM THANG 3 • SO 1/2013 binh thu&ng (< 35 U/ml) duOc coi la yeu to ten lutfng
quan trpng, cho phep danh gla si/ dap libg dieu bl cua l3enh va lien quan den th6i gian song them.
Nghien culi cua chung toi cho thay: Ty le song them 24 thang d nhom CA 12.5 sau dieu tri
<, 35 U/ml la 47,7% va d nhom CA 12.5 > 35 U/ml la 16,7%. Th6l gian song them trung binh 18,3 thang d nhom CA 12.5 sau dieu trj 35<
U/ml va 15,8 thang d nhom CA 12.5 > 35 U/ml, SLtkhac biet cd y nghia thong ke vdl p<0,05.
J Mark Ferrero va CS [ 5 ] nghien cu'u 105 BN urSMBT glai doan I I I tnsng do 66 BN c6 nong dp CA 12.5 trd ve binh thu'dng sau dieu trj < 35 U/ml, khi phau thuat kiem tra o bung (phau thuat Second look) khong thay ton thu'dng ung thir tren dai the. 6 nhO'ng BN CA 12.5 khong trd ve mufc binh thu'dng, 8 8 % con ung t h i / nhin thay khi md bung kiem tra. Nghien cxfu cung cho thay thdi gian song them bung binh 6 nhiirig BN co nong dp CA 12.5 < 35 U/ml la 44 thang va 13 thang d nhung BN c6 nong dp CA 12.5 > 35 U/ml.
Uu va CS [6] nghien culi tren 101 BN LTTBMBT cho thay thdi gian song them trung binh d nhutig benh nhan co nong dp CA 12.5 < 35 U/ml la 26 thang'va 5 thang neu CA 12.5 > 35 U/ml.
Lien quan glOU CA 12.5 sau dieu tri vdi tai phat: 6 nhij'ng BN CA 12.5 sau dieu tri > 35 U/ml nguy cd tai phat cao gap 3,8 lan so vdi cac BN < 35 U/ml (OR = 3,8 va 9 5 % CI = 1,66-8,7) va p = 0,001.
V. KET LUAN
Nghien ciJTu cho thay nong do CA 12.5 la yeu to tien lu'dng quan trpng lien quan tdi song them cua BN: Tru'dc dieu t r i , d nhu'ng BN co CA 12.5 tru'dc dieu t n < 300 U/ml co thdi gian song
them trung binh 18,9 thang cao hdn so vdl 16,7 thang d BN CA 12.5 > 300 U/ml (p<0,005).
Sau dieu trj: d nhu'ng BN co CA 12.5 < 35 U/ml CO thcJi gian song them trung binh la 18,3 thang cao hdn so vdl 15,8 thang d BN c6 CA 12.5
> 35 U/ml (p<0,05). Ty le tal phat gap d BN sau dieu tri CO CA 12.5 > 35 U/ml gap 3,8 lan d BN CO CA 12.5 < 35 U/ml.
TAI LIEU THAAA KHAO
1. Nguyen Ba Dure, Dao Ngoc Phong (2008),
"Dich te hoc benh ung thu"'. Nha xuat ban Y hqc, tr.l9-_21.
2. N g u y i n Van Ldi (2005), "Nghien culi dSc diem lam sang, mo benh hoc v? danh gia ket qua dieu tn ung thu' bieu mo buong trung giai doan III tai benh vien K tir 2000 - 2004", Luin vin tot nghiep bic sy noi tru. TrUdng Dai hoc Y Ha npi.
J . A3CC Cancer Staging Handbook (2010), From the AlCC Cancer Staging Manual, Edge, S.B.;
Byrd, D.R.; compton, C C ; Fritz, A.G.; Greene, F.L;
Trottj, A. (Eds.), 7th ed, XIV, 730 p, 130 tllus, Softcover, ISBN: 978 - 0 - 387 - 88442 - 4.
•4. Makar AP, Kristensen GB, Kaern J, et al (1992), "Prognostic value of pre and postoperative serum CA125 levels in ovarian cancer: New aspects and multivanate analysis", Obstet Gynecol; 79: 1002 - 1010.
5. Jean-M arc F errero , et al (1997), " Valeur pronostique de la normaiistation precoce du CA 125 au cours de la chimiotherapie des tumeaurs de I'ovaire stades III et IV", Bulletin du Cancer, 84, 7,722-8.
6. Liu PY, et al (1995), "CA 125 concentration 8 weeks alter treatment initiation independently predicts survival In patients with advanced epithelial ovarian cancer: a Southwest Oncology Graup study. Proc Am Soc Om Oncol I'i'i^; 14 : 266.
TYLE TIEN OAI THAO DUtTNG
TAI KHOA KHAM CHOA BENH THEO YEU CAU - BENH VIEN BACH MAI
fio Trung Quan ^; Tnnh Ngoc Canh^T 6 M TAT
Tien dai thao du'dng la tlnh trang du'dng mau cao hOn mii'c binh thu'dng nhuVig chUa du den mu'c chan doan DTO khl lam xet nghiem du'dng mau luc doi hoSc nghiem phap dung nap glucose. NhilYig ngu'di tien OTD 1. Dai hoc y Hi nol; 2. Benh vien da khoa tinh Thanh hoa Phan bien khoa hpc: GS.TS. Nguyin Kh^nh Trgch
neu khong dUOc phat hien sdm va phong chong thi se ben trien thanh benh OTD, dan den viec dieu tri rat ton kem va CO nguy cO gay nhieu bien chiihg nang ne.
Muc tieu: Nhan xet ty le tien dai thao duQng, dai thao du'dng 6 doi tu'dng den kham siit khoe djnh 1^ tai
Y Hpc VlgT NAM THANG 3 - S6' 1/2013 khoa Kham chOa benh theo yeu (3u - Benh vi?n Bach Mai.
Doi tu'ang vh phu'dng ph^p: nghien cult mo t i c3t ngang 1054 doi tu'dng tuoi tu" 30 den 69 den kham Slic khoe dinh ky tai Khoa Kham chUa b?nh theo yeu cau - Benh vi?n Bach Mai tu' th^ng 2 -10/2012, du'dc l^m nghiem ph^p dung n?p glucose va chSn doan tien dil thao du'dng theo WHO - nSm 1999.
Ket q u i : Ty I? tien d i i thio du'dng l i 38%. Ty I?
benh dai thao du'dng la 9%.
SUMMARY
THE PREVALENCE OF PREDIABETES I N OUTPATIENT DEPARTMENT OF BACH MAI
HOSPITAL
Background: The term prediabetes refers to people who have impaired fasting glucose (100-125 mg/dL), impaired glucose tolerance (2-hour postglucose load of 140-199 mg/dL), or both. If prediabetes is not detected, the progression to type 2 diabetes mellitus is not inevitable. So treament is more expensive and increment complications.
Objectives: To identify the prevalence of prediabetes, diabetes in outpatient department of Bach mai hospital.
Methods: A cross - sectional, descriptive study was carried out on 1054 persons, from 30 to 69 years ago, who check health in outpatient department of Bach mai hospital from 2 to 10/2012, implemented Oral glucose tolerance test and diagnose prediabetes according to cntena of WHO - 1999.
Results: The prevalence of prediabetes is 38%, The prevalence of diabetes is 9%.
Keywords: prediabetes
I.
OAT VANo f
Tien dai thao du'dng la tinh trang du'dng mau cao hdn mu'c binh thu'dng nhu'ng chu'a du den mu'c chan doan DTO khl lam xet nghiem du'dng mau luc ddi hoac nghiem phap dung nap glucose. Tien OTO bao gom: Rdi loan dung nap glucose (Impaired Glucose Tolerance - IGT) va Roi loan glucose mau luc ddi (Impaired Fasting Glucose - IFG). NhO'ng ngu'di tien OTO neu khdng du'dc phat hien sdm se tien trien thanh benh OTO, dan den viec dieu tri rat tdn kem va CO nguy cd gay nhleu bien chutig n3ng ne. Ty le tien dai thao du'dng d cac nu'dc tren the gidi dao dpng tii 3,0% den 22,7%. Viet nam cong bd ty le tien OTD tiT nhu'ng nam 2001 la 5 , 1 % (dieu tra tai 4 thanh phd ldn), nam 2002 la 7,3% (dieu tra toan qudc). Gan day chu'a cd nhleu nghien ctTu mdi thdng bao ve tinh trang tien OTO. Oe gdp phan phat hien va danh gia ty le tien DTO, tiT do
du:a ra nhffng kien nghj phiJ hdp nhSm ngSn ch3n tien DTO tien trien thanh benh DTD chung toi tien hanh thu'c hien de tai " Ty le tien dSl thSo dtfdng tai khoa Kham chu'a b$nh theo yeu cSu - Benh vien Bach Mai"y<i\ muc tieu:
Nhan xet ty le tien dai thao dudng, dai thio dwdng d ddi tu'dng den kham s&c khoe dinh ky tal khoa Kham chO'a benh theo yeu cau - Benh vien Bach Maf
II. o 6 l TUpNG VA PHL/ONG PHAP NGHIEN COU 1 . fioi t i / ^ n g n g h i e n cu'u: 1054 doi tu'dng tudi til" 30 den 69 den kham su'c khde djnh ky tai Khoa Kham chffa benh theo yeu cau - Benh vien Bach Mai tCr thang 2 den thang 10/2012, du'dc lam nghiem phap dung nap glucose va chan doan tien dai thao du'dng theo WHO - n3m 1999, khi cd it nhat mot trong hai tieu chuan sau:
+ Roi loan dung nap glucose (IGT): neu m u t glucose huyet tu'dng d thdi diem 2 gid sau nghiem phap tang du'dng mau tff 7,8 mmol/l (140 mg/dl) den 11,0 mmol/l (198mg/dl) va glucose huyet tffdng luc ddi < 7 mmol/l (126 mg/dl).
4- Suy giam dung nap glucose mau luc doi (IFG): neu Iffdng glucose huyet tffdng luc doi (sau 3n 8 gid) tff 6,1 mmol/l (110 mg/dl) den 6,9 mmol/l (125 mg/dl) va glucose huyet tffdng d thdl diem 2 gid (neu do) cua nghiem phap tang dffdng mau dffdi 7,8 mmol/l ( < 140 mg/dl).
Tieu chuan loal trd: Da dffdc chan doan DTO hoac tien dai thao dffdng trffdc do; Dang dung thuoc cd anh hu'dng den dffdng huyet:
cortcoid, thiazid, thuoc u t che beta, phenytoin, add nicotinic...; Dang mac benh cap b'nh, benh tam than; Oa an trong vdng 8 gid; Phu nff c6 thai.
2. Phu'dng p h a p n g h i e n c u t i : - Thiet ice nghien cuti: phffdng phap mo ta c3t ngang.
Ngi dung nghien cthi:
+ Hp ten, tuoi, dja chi, dien thoai.
+ Nghiem phap dung nap dffdng mau: Nhjn ddi tff 8 den 12 gid. Xet nghiem Glucose mau tlnh mach luc ddi (GO) trffdc khi lam nghiem phap. Cho benh nhan uong 75g glucose khan pha trong 250ml nffdc de nguoi, uong trong vong 5 philt. Sau 2 gid lam lai xet nghiem glucose m^u tlnh mach lan 2 (G2).
- Tieuchuan xac djnh tien OTD: Theo ADA 2003 3. Xiir ly so lieu: theo phu'dng phap thdng ke y hpc vdi phan mem SPSS 16.0.
Y HOC VllT NAM THANG 3 - S61/2013 III. KET Q u A NGHIEN CGU
1 , D a c d i e m c h u n g :
Bang 1, Phan bo gicfi tfnh va tuo'i trunq binh cua doi tu'ang nqhien cifu Pol tu'ang
NiJ Chunq
So lu'dnq (N ( % » 332 (31.5%) 722 (68.5%) 1054 (100%)
Tuoi (TB ± SD) 49.0 ±9.11 48.6 ± 9.32
Tuoi trung binh cua nhom nghien cu'u la 48.6 ± 9.32, thap nhat ia 30, cao nhat la 69. Tuoi trung binh cua nam la 47.8 ± 9.71, ciia nCf ia 49.0 ± 9.11.
Nam CO 332 ngyfti, chiem 31.5%, niTco 722 ngu'di, chiem 68.5%.
2. Oac d i e m g l u c o s e m d u c u a n h o m n g h i e n cu'u 2,1. &ac diem glucose mau luc ddi {GO) Bang 2, Oac diem glucose mau luc dpi theo qidi
chi so TB ± SD (mmoi/l)
TV IS GO BT (%) Tv le IFG (%) Tv le DTD (%)
Tonq
Chung N = 1054 5.52 ±1.01
65.5 30.0 4.5 100
Nam N = 332 5 56±1 10
60.9 33.4 5.7 100
NO' N = 722 S.46±0.96 67.7 28.4 3.9 100
P
P>0.05
Du'dng mau doi trung binh ciJa cac doi tiTOng nghien CLTU ia 5.52 ± 1.01 mmol/i, thap nhat ia 3.9 mmol/i, cao nhat la 16.6 mmoi/l. Khong ca su' l<hac biet co y nghia thong ke giiia nam va niJ (p > 0.05). Ty
\e nguSi cn GO binh thu'dng la 65.5%, ty ie mac IFG ia 30%, ty ie mac OTD theo GO ia 4.5 %.
Dinh (liirinig T).7
TSIt%
Bieu do 1. Ty ie GO theo nhom tuoi
Gia tri GO trung binh theo nhom tuo'i 30-39 ia 5.31 ± 1.07mmoi/i, 40 - 49 ia 5.37 ± 0.75mmoi/l, 50 - 59 la 5.68 ± 1.06 mmoi/i, 60 - 69 ia 5.79 ± 1.22 mmoi/i. Gia tri GO tang dan theo cac nhdm tuoi, sir khac biet nay co y nghTa thong ke (p < 0.001). Ty le doi tu'dng bj roi loan du'dng mau doi va OTD cting tang dan theo tuoi, thap nhat d nhom tuo'i 30 - 39 vdi 18.8 % IFG va 1.5% OTO, cao nhat it nhom tuoi 60 - 69 vdi 39.6% IFG va 7.2% OTO.
2,2, Bac diem glucose mau sau 2 gid (G2) Chi so
TB ± SD (mmol/i) Tv ie G2 BT (%) Tv le IGT (%) Tv le OTD (%)
Tong
Chung 7.85 ± 2.56
62.5 29.5 8.0 100
Nam 7.77 ± 3.01
66.9 24.1 9.0 100
\KI 7.89 ± 2.32
60.5 32.0 7.5 100
P
>o.os
Du'dng mau trung binh sau 2 gid iam nghiem phap dung nap giucose ciia cac doi tu'dng nghien oili ia 7,85 ± 2.56 mmol/l, thap nhat la 3.3 mmol/i, cao nhat ia 24.2 mmoi/i. Khong cd sU khac biet coy nghia thong ke ve trung binh G2 giu'a nam va n i l (p > 0.05). DUa vao ket qua G2 chimg toi thay ty le ngu'di co G2 binh thu'dng la 62.5%, ty ie ngu'di mac IGT la 29.5%, mac OTO la 8%.
Y H p c V l l T NAM T H A N S 3 - S 0 1 « 0 1 3
• r y i « % , 1 , , • ' "
Binh Ihirfrng IGT
• DTD
.^^^m^JL
3().39 40-49 .<I0-S9 (i(l-69
Bieu do 2. Ty le G2 theo nhdm tudi
Gia tri G2 trung binh theo nhdm tuoi 30 - 39 la 7.16 ± 1.98 mmol/l, d nhdm tudi 40 - . 4 9 la 7.51
± 2.36 mmol/l, d nhdm tudl 50 - 59 la 8.28±2.76 mmol/l, d nhdm tudl 60 - 69 la 8.57±2.82 mmol/l.
Gia trj trung binh G2 tSng dan theo cac nhdm tuol, sff khac biet nay cd y nghia thong ke (p < 0.001).
f y le ddi tffdng bl rdi loan dung nap glucose va DTO cung t3ng dan theo tudi.
2.3. Kit qua G2tren nhii'ng ngu'di c6 IFG: Ivong nghien cffu cd 316 ngffdi mac IFG (30%).
Ket qua:
Bang 4. Ket qua G2 tren nhffng ngu'di cd IFG G2
IGT DTO Binh thudnq
Tonq
IFG 174 44 98 316
Tv M »/o 55.1 13.9 31 100 O nhij'ng ngu'di co roi loan du'dng mau doi, iam nghiem phap dung nap glucose thi co 5 5 , 1 % mac IGT, BTO la 13.9%, 3 1 % cd G2 binh thu'dng.
IV. BAN LUAN 1 . Vie t u o i v a g i d i
Tud'i: Chiing toi nghien ciru 1054 ngudi den kham sire khde djnh ky tai Khoa Kham chu'a benh theo yeu cau - Benh vien Bach Mai cho thay: tuoi trung binh ia 48.6 ± 9.32, tuoi thap nhat ia 30 va cao nhat ia 69. Tuo'i trung binh ciia nam ia 47.8
± 9.71, ciia nff la 49.0 ± 9 . 1 1 . Nhom tuoi 30 - 39 chiem 18.7 % , nhdm tuoi 40 - 49 chiem 3 3 . 1 % , cao nhat d nhdm tuoi 50 - 59 vdi 35.0%, nhdm tuoi 60 - 69 chiem 13.2%.
G'/o'/,'Trong nghien citu ciia chiing toi, phan bo ty ie nu" ia 68.5%, nam ia 31.5%. Trong 400 ngudi mac tien OTO, ty ie nif la 274 ngu'di, cung chiem ty le 68.5%. Nhu' vay ty le tien OTD d nam va nu' la tu'dng dUdng nhau, tifc ia phan bd theo gidi d ngudi tien OTO trong nghien ciru nay la nam/nu' = 1/2.2. Ty le n(?/nam cao con thay trong Diabcare - Asia (1998) va Diabcare Viet Nam (1998 - 2003) la 1/2.
2. Ve t y le mSc t i e n OTO v J OTO 2.1, Di/a vao dwdng mau luc ddi:
Trong nghien ciru ciia chung toi, xet nghiem du'dng mau ddi ciia 1054 doi tu'dng nghien ciru thu dUdc ket qua la 65.5% cd (30 binh thudng, ' 30% mac IFG va 4 . 5 % mac DTO. Ty le nay d
nam la 60.9%, 3 3 . 4 % , 5.7% va d nff ia 67.7%, 28.4%, 3.9%.
Nghien cffu ciia Le Quang Minh (Bac Kan) tren 811 doi tffdng khde manh tuoi tff 30 - 64 cho ket qua GO co ty le 4 4 . 9 % binh thffdng, 36.7% IFG, 18.4% ia DTO. Ket qua nay CO IFG cao hdn chiing toi va dac biet cd t^ le OTD la cao hdn han, tdi 18.4%. SiJ khac nhau nay cd the do trong nghien cffu cua Le Minh Quang co nhieu doi tuting la can bp, dieu kien cupc song cua ho cao hdn, nen nguy cd ve benh OTD cung cao hdn.
Theo Hoang Kim U'dc, Nguyen Minh Hiing, Nguyin Le Minh nghien cu\i tai Thai Nguyen (2006), doi tffdng tff 25 - 69 tuoi cho thay t } le dai thao dffdng type 2 la 5,3% va roi loan glucose mau luc ddi ia 2 2 , 8 % . Ket qua nay thap hdn ciia chiing toi vi nghien cij\i tff tuoi 25 den 69, con chimg toi nghien cffli tff tuoi 30 den 69.
2.2. DUa vao nghipm phap dung nap glucose:
Trong nghien ciru ciia chung toi, nghi&n phap dung nap glucose dffdc tien hanh tren tat ca cac doi tuWng nghien culj. K S qua nhff d bang 3 cho thay cd 29.5% ben DTD, 8 % la DTD. O nam, ty le do ia 24.1% va 9%, d nff la 32% va 7.5%.
Y HOC VlgT NAM THANG 3 - SO 1/2013 Phan tich ket qua trong 400 ngffdi mac tien
DTD, cd 98 ngu'di chi cd IFG chiem 24.5%, 128 ngffdi chi cd IGT chiem 3 2 % , 174 ngffdi cd ca IFG va IGT chlem 43.5%.
PhSn tich ket qua lam nghiem phap dung nap glucose d 316 ngu'di cd roi loan dffdng mau doi (30%), chung tdi thay: cd 5 5 . 1 % la tien DTO, 13.9% la OTD, 31 % cho ket qua binh thffdng.
Theo ket qua nghien cffu cua DffOng Bich Thuy, Trffdng Da Uyen va CS nghien cffu tren 247 trffdng hdp cd rdi loan dffdng mau luc ddi sau khl tien hanh nghiem phap tang dffdng mau thi thay cd 38.9% cd rdi loan dung nap glucose mau, 22.7% dffdc xac djnh la dai thao dffdng typ 2va 38.4% dung nap glucose binh thffdng [1].
Theo Tran Thi Doan nghien cffu 160 ngffdi tien DTD, ty le chi cd IFG la 2 3 . 1 % , chi cd IGT la 28.1%, vffa cd IFG vffa cd IGT la 48.8%. Ket qua ciia chung tdi cung tffOng dffOng vdi ket qua nay.
Theo Kham Phoong Phu Vdng nghien cffu tren 358 benh nhan tien DTO, ty le chi mac IFG la 22.4%, chi mac IGT la 25.7%, ty le mac ca IFG va IGT la 46.6%.
Theo Tran Quang Trung va Hoang Thj Thu Hffdng nghien cffu tren 50 ngffdi cd rdi loan dffdng mau ddi, tudl tff 30 den 65, phat hien 16.36% bl OTO va 52.73% bl RLDNG. Theo nghien cffu ciia Ta Van Binh (200i3) tai 4 tinh Phu Tho, Sdn La, Thanh Hoa va Nam Oinh Iffa tudi 30 - 6 4 thi tyle nay la 8.8%.
Theo tac gia Dffdng Bfch Thuy va CS nghien
cffu tai Benh vien Hoan My, Thanh phd Ho Chi Minh, tren nhffng ddi tffdng cd glucose mau luc ddi > 6 , 1 - 6.9 mmol/l thay cd 42.3% so ddi tffdng bi rdi loan dung nap glucose mau va 30.9% so ddi tffdng dffdc chan doan dai thao dffdng typ 2.
V. KET LUAN
Qua nghien cffu 1054 ddi tffdng tudl tff 30 den 69 dl kham sffc khde djnh ky tai Khoa Kham chffa benh theo yeu cau - Benh vien Bach Mai tudl chimg tdi nhan xet sau:
- Ty le tien dai thao dffdng la 38%.
- Ty le benh dai thao dffdng la 9%.
TAI LIEU THAM K H A O
1. Du'cfng Bich Thuy, Tru'dng Da Uyen, Nguyen Hu'u Han Chau (2006), 'Ty le roi loan dung nap glucose tren cac doi tu'dng co roi loan du'dng huyet luc doi", Yhoc thwc hinh, so 14, 15 2. ywGenuth S; Alberti KG; Bennett P et al
(2003), "Follow-up report on the diagnosis of diabetes mellitus", Diabetes Care, 26, pp. 3160.
3. ZyJayawardena R, Ranasinghe P, Byrne NM, et al. (2012), "Prevalence and trends of the diabetes epidemic in South Asia: a systematic review and meta-anaiysis", BMC Public Health, 12 (1), pp. 380.
^. ZyLee JE,Jung SCaa (2003), "Prevalence of Diabetes Mellitus and Prediabetes in Dalseong- gun, Daegu City, Korea", Diabetes i^etab J, 35 (3), pp. 255-63.
NGHIEN CllfU TiNH HJNH BENH DA VA BENH PHONG TAI MOT SO XA CO TY LE LUU HANH BENH PHONG CAO NAM 2011
Nguyen Duy H U n g * , N g u y i n Thj Thanh H u y e n * , Bao Hu'u G h i * , Oinh Hu'u N g h j * , Ha Tuan M i n h * , Nguyen Tien T h a n h *
TOM T^T Myc tieu:
- Khao sat tinh hinh benh phong tal mgt so xa co ty le lu\j hanh benh phong cao d 7 tinh tien hanh dieu tra dich te benh phong.
- Danh gla md hinh benh ngoai da tai mot so xa CO t/ le \\iu hanh benh phong cao d 7 tinh tien hanh aieu tra djch t l .
Phu'ang phap; Nghien cutj m6 ta cat ngang va cd
* Benh vien Da lieu TW
Phan bien khoa hpc: PGS.TS. Nguyin HO'u Sau
mau toan bg dan cu' song tren dia ban 17 xa dUOC lua chgn cua 7 tinh tien hanh kham dieu tri benh da phat hien benh phong: Yen Bai, Quang Nam, Kon Tum, Gia Lai, Binh Phu'dc, Kien Giang, Ca Mau.
Ket qua: Chiing toi da phat hien 5 benh nhan (BN) phong d Gia Lai (1 BN), Kon Tum (2 BN), Binh Phu'dc (2 BN). Tat ca cac BN phong deu la the nhieu vi tmng (MB).
Ty le phat hien (TLPH) benh nhan phong mdi la 4,69/100.000 la cao hdn nhieu so vdi mot trong 4 tieu chi loai trif benh phong d cap tinh. Ty le mac benh da chung
