1.The laboratory inventory handling with poliovirus and potential infectious materials in Mongolia
Ichinkhorloo B ; Ariuntugs S ; Ali KH ; Altantuya L ; Enkhtuya B ; Ankhmaa B ; Gansmaa M ; Enkhjargal B ; Mandakhtsetsen KH ; Sainchimeg B ; Sodbayar D
Mongolian Medical Sciences 2016;178(4):7-11
BackgroundIn 1988, the Forty-first World Health Assembly adopted a resolution for the Global Polio Eradication.Since the initiative was launched, number of polio cases has fallen by over 99%. Today, only threecountries in the world, Afghanistan, Pakistan and Nigeria - remain polio-endemic. The Polio Eradicationand Endgame Strategic Plan of 2013-2018 calls for the gradual eradication of wild virus strain and thevaccine virus strain at the same time. In order to prevent the border transmission of wild type poliovirus,virus leakage from laboratories, it is required to conduct inventory of laboratories handling poliovirus andpotential infectious materials every 2 year.GoalTo identify laboratories handling poliovirus and potential infectious materialsMethodsSurvey of laboratories handling poliovirus and potential infectious materials was conducted amongstate, private, clinical, biomedical and environmental testing in total of 127 laboratories operating in21 provinces and 9 districts of Ulaanbaatar city by questionnaire. Survey questionnaire consists of 6sections (general, sample storage, laboratory biosafety, staff knowledge, information source, trainingand etc.). Study results were processed using SPSS-19 statistical programme.Results34.7% of 96 biomedical laboratories were analyzed stool samples. These laboratories were analyzedrotavirus (17.0%), intestinal bacteria (67.0%), Helicobacter (14.3%), parasite and other indicators (1.7%)in stool samples. 43.8% of laboratories were stored stool samples for one day and 3.1% up to oneyear. From 31 environmental testing laboratories 73.3% were bacterialdetection test on environmentalsamples. 60% of wastewater samples were collected from rivers, 16% on entrance to wastewatertreatment plant and after biological treatment combined, and 24% from other sources. Soil sampleswere collected near waste disposal and other sources (46.4%), and from unknown sources (53.6%).24.1% of all laboratories were stored environmental samples for 3 days, 3.4% for 45 days. Accordingto results, surveyed laboratories did not store samples for more than 1 year. Also, none of surveyedlaboratories (100%) were not stored poliovirus and potential infectious materials.Conclusion· The investigated laboratories were not stored poliovirus and potential infectious materials.· The biosafety and biosecurity status of laboratories should be improved in near future throughenhancing knowledge of laboratory workers and organizing training related to biosafetyandbiosecurity.
2.Circulation of enteroviruses among healthy children under 5 years of age and clinical features of infection
Ariuntugs S ; Ankhmaa B ; Tuguldur B ; Altanchimeg S ; Altantsetseg D ; Sarangua G ; Oyunbileg J ; Ichinkhorloo B
Mongolian Medical Sciences 2019;189(3):40-49
Introduction:
Major outbreaks of infectious diseases caused by enteroviruses (EV) have been reported in recent
years. As of 2017, in Mongolia, hand, foot and mouth disease, or HFMD, accounts for 13.7% of all infectious diseases. The purpose of this study was to investigate the circulation of EV among healthy children, and clinical characteristics of infection.
Materials and Methods :
The analysis of EV circulation was conducted on Polio Laboratory data of 1172 specimens, collected in
2013-2018, from 9 districts of UB and 21 provinces of Mongolia. Also specimens of 239 patients, who
underwent outpatient and inpatient treatment at the NCCD in 2014-2018, were randomly selected and
stool samples were collected. Clinical symptoms of patients were analyzed and virus isolation analysis
was performed in order to confirm the diagnosis.
Results:
Children from 1 month of age to 5 years have participated in the study and the average age was 2 years and 5 months. The enterovirus rate among healthy children was 20.1%. Virus circulation rate was highest in 2013 (37.2%), lowest in 2014 (11.8%). The peak of circulation is observed in May and October, while the minimum rate is in July.
Out of selected patients 52.7% (n=126) were diagnosed with HFMD, rash infection occurred in 28.5%
(n=68), acute flaccid paralysis-18.8% (n=45). EV was detected in 56.4% (n=135) of the collected stool
samples.
Children from 1 month of age to 5 years have participated in the study and the average age was 2 years and 5 months (95% CI:2.5 ±0.1). 49% (n=578) of participants were female, 50.7% (n=594) were male. The enterovirus rate among healthy children were 20.1% (n=236; 95% CI: 20.1 ± 0.55). Virus circulation rate was highest in 2013 (37.2%), lowest in 2014 (11.8%). The peak of circulation is observed in May and October, while the minimum rate is in July. Although the enterovirus isolation rate was relatively high among children under 3, there was no statistically significant difference (p>0.05), as well as there was no difference in gender (p>0.05). As for the EV circulation by region, the highest prevalence rate is found in Central region (27.5%), while the lowest is in the Eastern region (12.7%) with no statistical significance by regions (p>0.05).
Conclusions
Among children, HFMD is a common disease, that caused by EV. Enterovirus infection can often cause
fever, flu like symptoms as well as spotted, maculopapular rash. The EV isolation rate of 20.1% indicates
that the incidence of enterovirus is characterized by symptoms of influenza-like illness or is asymptomatic.
3.Knowledge and attitude of population on measles vaccination
Nomin-Erdene B ; Ichinkhorloo B ; Ariuntugs S ; Ankhmaa B ; Tuguldur B ; Gansmaa M ; Budkhand O ; Khaliunаа T ; Nomin B ; Sainbayr Ts ; Oyunbileg J
Mongolian Medical Sciences 2021;196(2):69-74
Introduction:
Vaccination is a cost-effective intervention to prevent major illnesses that contribute to child mortality
in the country. Increase in parental knowledge abour vaccination will lead to increase in vaccination
rates of children. The main aim of our study was to assess the knowledge, attitudes and perceptions
of vaccination. People’s knowledge about immunization and their attitudes toward them are likely
influence uptake.
Goal:
The main purpose of the study is to evaluate the knowledge and attitude of the population towards
measles and to clarify their satisfaction and understanding of the measles immunization program.
Materials and Methods:
We conducted cross-sectional study, involved participants from 3 aimags and 6 districts covered
voluntarily. Total participants were 509. We used to online model and with the participant’s self-answer closed questionnaire.
Results:
76% of the respondents were female and 24% were male. 64.1% of respondents who have children
of 0 to 5 years of age, had little or bad knowledge towards immunization schedules against measles.
Overall, the general attitude towards vaccines was positive, but the knowledge about significance of
vaccines was weak. Further, district and province family doctors need to pay particular attention to
increasing awareness and knowledge on importance of vaccines among families with young children.
It is necessary to conduct extensive, long-term research and training among population to evaluate
their knowledge and attitude towards measles, its vaccine and prevention, and to identify causes of
lack of knowledge.
Conclusion
Our study shows the importance of good physician–patient communication in improving knowledge
attitude and practice of parents towards their children’s vaccination.
4.Results of normal microflora of the skin of the population covered by the study of immunosuppression and risk factors for injectable infectious diseases
Budkhand O ; Ichihkhoroloo B ; Ankhmaa B ; Ariuntugs S ; Nomin-Erdene B ; Khaliun T ; Gansmaa M ; Baigali B ; Altanchimeg S ; Dashpagma O ; Oyunbileg J
Mongolian Medical Sciences 2021;196(2):75-83
Introduction:
Researchers have found that people living in polluted areas have a lower ability to resist skin bacteria
and increase the number of skin microflora. Decreased immune function increases the risk of sore
throat, influenza, respiratory infections, pneumonia and gastrointestinal diseases. One of the main
indicators of the human immune system is the normal microflora.
Goal:
To study the relationship between normal human microflora and specific immunity.
Material and Methods:
This study was conducted within the framework of the project “Effects of non-specific immune factors
on injectable infectious disease immune system”. The survey sampled 10 households from Dornod
aimag, 8th khoroo of Chingeltei district, Ulaanbaatar city, and 3rd khoroo of Baganuur district. A
total of 176 people aged 6 months to 50 years were involved. A total of 528 swab samples and 31
blood samples were collected from the throat, tonsils, skin and mucous membranes to study the
relationship between normal human microflora and specific immunity.
The research methodology was discussed at the meeting of the Academic Council of the Ministry of
Social Welfare and the Medical Ethics Review Committee under the Ministry of Health (January 5,
2018, Resolution 646) and the research was approved.
Results:
The total number of normal microorganisms in the skin and mucous membranes of the study
participants changed, and the number of hemolytic strains and fungi increased. 58%-67% of the
participants had normal and long-term immunity against diphtheria and tetanus, while 5% -14% were
not. This result was as high as in urban and rural areas.
Conclusion
This result was as high as in urban and rural areas. As the age group increases, the level of the
body’s specific immunity decreases, the structure of the normal microflora changes, and the number
of fungi and hemolytic bacteria increases. Furthermore, it is necessary to study specific and nonspecific immunity in detail in relation to environmental pollution indicators.