Article Text

Download PDFPDF
Short report
Relationship between flood severity and risk of hospitalisation in the Mekong River Delta of Vietnam
  1. Dung T Phung1,
  2. Joshua L Warren2,
  3. Cordia Ming-Yeuk Chu3,
  4. Robert Dubrow4
  1. 1 School of Medicine, Griffith University Griffith Health, Gold Coast, Queensland, Australia
  2. 2 Department of Biostatistics, Yale School of Public Health, Yale University, New Haven, Connecticut, USA
  3. 3 Centre for Environment and Population Health, Griffith University, Nathan, Queensland, Australia
  4. 4 Department of Environmental Health Sciences and Center on Climate Change and Health, Yale University School of Public Health, New Haven, Connecticut, USA
  1. Correspondence to Dr Dung T Phung, School of Medicine, Griffith University Griffith Health, Gold Coast, QLD 4111, Australia; d.phung{at}; Professor Robert Dubrow; robert.dubrow{at}


Objective To examine the relationship between flood severity and risk of hospitalisation in the Vietnam Mekong River Delta (MRD).

Methods We obtained data on hospitalisations and hydro-meteorological factors during 2011–2014 for seven MRD provinces. We classified each day into a flood-season exposure period: the 2011 extreme annual flood (EAF); 2012–2014 routine annual floods (RAF); dry season and non-flood wet season (reference period). We used province-specific Poisson regression models to calculate hospitalisation incidence rate ratios (IRRs). We pooled IRRs across provinces using random-effects meta-analysis.

Results During the EAF, non-external cause hospitalisations increased 7.2% (95% CI 3.2% to 11.4%); infectious disease hospitalisations increased 16.4% (4.3% to 29.8%) and respiratory disease hospitalisations increased 25.5% (15.5% to 36.4%). During the RAF, respiratory disease hospitalisations increased 8.2% (3.2% to 13.5%). During the dry season, hospitalisations decreased for non-external causes and for each specific cause except injuries.

Conclusions We observed a gradient of decreasing risk of hospitalisation from EAF to RAF/non-flood wet season to dry season. Adaptation measures should be strengthened to prepare for the increased probability of more frequent extreme floods in the future, driven by climate change.

  • public health
  • climate
  • epidemiology

Data availability statement

Data are available on reasonable request.

Statistics from

Data availability statement

Data are available on reasonable request.

View Full Text


  • Funding DTP received an Endeavour Fellowship from the Australian Government Department of Education and Training (ID: 6466_2018) to do postdoctoral research at Yale School of Public Health. RD received support from the High Tide Foundation.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.