1.Comparison of secondary attack rates in ger and apartment areas, Mongolia, November 2009
Mongolian Medical Sciences 2011;168(1):95-99
Background: Since its first identification of Pandemic H1N1 2009 in Oct 12, 09 in Mongolia, the cases have increased dramatically spreading in much of cities and provinces of Mongolia. We aimed to identify and compare the transmissibility of the infection in different household settings, so to add understanding of special characteristics of this infection.Methods: We selected 20 laboratory confirmed 2009 H1N1 influenza as the index cases from the National Surveillance System. We searched for Influenza like illness (ILI) cases in the households by questioning index-cases and household-contacts. Secondary case was defined as household-contact who developed one of the signs such as fever, dry cough, sore throat, runny nose and diarrhea within one week of symptom onset in index case. We calculated and compared attack rates in ger and apartment areas.Results: Transmissibility of 2009 H1N1 influenza was studied in 20 households. Each half was from ger and apartment residency of Ulaanbaatar city, Mongolia. The study involved 20 indexcases and 72 household-contacts. Secondary transmission occurred in 13 (65%) households with 22 (30.5%) household cases of probable Pandemic H1N1 influenza virus infection. The incidence in ger and apartment areas was 36.1% and 25.0% relatively. Cases in ger residency were 1.2 times more likely than in apartment residency to develop ILI (RR = 1.2, 95%CI: 0.86- 1.60).Conclusions: Overall secondary attack rate in this study was 30.5%, which is similar to that of 30% secondary attack rate for laboratory-confirmed 2009 H1N1 influenza in tourist group members in China. Though statistically not significant, the risk estimation of secondary ILI compared in ger and apartment residency indicates ger area residents have 20% higher risk for ILI development after illness in index case.
2.Research result of driver behavior when driving, Ulaanbaatar, 2010
Suvd B ; Dolgorkhand A ; Shurenchimeg B ; Ariunbolor O
Mongolian Medical Sciences 2013;163(1):164-172
IntroductionEvery day over the 16000 of people, every year 5 million people pass away due to accident and injury and 500 million people become invalid in the worldwide. It is 9.8% of total death caused by disease, 12.3% of total morbidity. As a result of Mongolian statistical yearbook 1997-2010, “Accident, injury” was at third place of cause of death and at fifth place of morbidity.GoalTo detect risk behaviors which influence on distracting attention of driver and to establish recommendation to change risk behavior during driving.Materials and MethodsThe research will be conducted by quantitative method (questionnaire) and qualitative method (observation and interview). There is 106.848 of cars in Ulaanbaatar and about 10% (n=300) of these is public transportation. 50 of drivers participated at separate interview to detect risk behavior during driving. Research team observed 25 public transportation for 3 hours to reveal driver risk behavior. The data was collected from central 6 districts in Ulaanbaatar.Results:The research involved 290 of drivers from central 6 districts, going to 8 itineraries in Ulaanbaatar. Participants are age of 19-64 and average was 37.4±8.3 age. Age of 30-39 was 44.1 % (128). 92.1% (267) of 290 drivers was drivers of bus, microbus. Most (36.3%, 61) of 168 (57.9%) who not wear seat belt said that not accomplished to use seat belt, 34.3% (56) said that it disturbs to drive a car. 91.7 of drivers said that they are calling during driving. Other 8.3% who are not calling during driving don’t use phone. 99.3% of total drivers listens FM radio, 97.9% talks with someone who sitting near in the car, 95.5% see advertisement near the way which influencing to go down attention of driver. 93.1% of participants answered that don’t drink alcohol during driving. Do you drive a car if there is necessary to drive when using alcohol?-60.0% of them absolutely don’t drive, 34.1 said that a car is driven by another person. 95.5% of participants said that there is no special seat for children in a car. But 46.2% of them has good habit to sit children in back side of a car. But 27.6% said that have habit to sit in front side of a car, 25.9%- anywhere. As a result of research we observed driver common views of public transportation such as sudden forcefully braking, calling, smoking, sitting with anyone in driver cabin, quarrelling with other drives.Conclusion:Drivers demonstrate following behaviors which may leading to traffic accident, involved or not involved in the traffic rule: Most of driver of public transportation bus don’t wear seat belt; Don’t require to wear seat belt from passenger sitting in the back side of car, no seat belt, and cover hasp of seat belt by covering; They have habit to drive a car when using alcohol; Call for long period, quarrel with calling person with loudly, be no normally; Incomplete machine leads to worry for driving period; Don’t convert light at night;
3.The contribution of field epidemiologists to the public health sector in Mongolia
Tsolmon B ; Nyamsuren Ts ; Dolgorkhand A ; Suvd B
Mongolian Medical Sciences 2021;198(4):47-53
Introduction:
Field epidemiology training (FET) was first established in 1951, named as Epidemics Intelligence
Service, next to the Centres for Disease Control and Prevention of USA. At present, FET is conducted
in over 50 countries in the world and the training is based on the main principle of promoting utilization
of theories of epidemiology in public health practice and evidence-based decision making. Main goal
of FET is to strengthen capacity and infrastructure of the public health system and to improve people’s
health as a result of forming a core team of professionals, which will deliver public health services in a
particular country, survey any country-specific public health issues, and provide evidence.
MFETPs have been implemented in Mongolia since 2009 with support from Ministry of Health (MOH)
and World Health Organization (WHO). To ensure structural and organizational sustainability of the
training, the programme has been integrated into the National Centre for Communicable Disease
(NCCD) under the auspices of MOH and the trainings have been conducted nationwide. MFETPs last for one year, which includes 1-2 months of classroom training and 3-11 months of field internship by trainees. The training graduates should be skilled to use the science of epidemiology in studying
public health issues and to deliver evidence-based conclusions and recommendations.
Goal:
To evaluate of MFETP graduates’ knowledge, skills and their contribution to the public health system
Method:
We conducted a cross-sectional online survey link between October 2019 and March 2020 through
Mongolian field epidemiology alumni networks. Survey questions included demographic details of
participants, along with their technical background, level of formal education, topics studied during
epidemiology training, and years of experience as an epidemiologist. We specifically targeted FETP
alumni, however the survey was open to all people who had studied MFETP.
Results:
In total, 55 field epidemiologists (77% of all graduates) responded to the survey. Participants had
a range of formal public health and epidemiology training backgrounds. Of the total graduates, 19
(30%) are currently working at NCCD, of whom 3 are head of department. A total of 7 (11%) graduates
work in rural health centers and health centers, while 6 (10%) graduates work in the tertiary level.
In addition, there are 2 graduates working in the Ministry of Health. 80.6% (25/31) were involved in
outbreak-response activities and 93.9% (31/33) conducted operational research, 91.4% (32/35) said
that the surveillance analysis was conducted and 81.5% (22/27) performed fundamental researches
at least one times. One graduate had an average 3.7 study and analysis during the course of the
study, and increased to 7.7±12.4 after graduation. Particularly, the operational study (4.1 ± 8.7) and
the outbreak study (3.1 ± 4.5) have increased.
Conclusion
Our study has demonstrated that applied epidemiology workforce training must evolve to
remain relevant to current and future public health challenges.
4.The attack rates of the pandemic influenza infection, Ulaanbaatar, November 2009
Amarzaya S ; Altanchimeg S ; Suvd B ; Oyun M ; Enkhjargal T ; Tuul TS ; Dolgorkhand A ; Surenkhand G ; Ambeselmaa A
Mongolian Medical Sciences 2010;152(2):47-52
BACKGROUND: In Ulaanbaatar, the first case of the pandemic influenza infection has been reported on 12 October 2010.By November 9, a total of 929 cases laboratory-confirmed had been reported to National Center for CommunicableDiseases (NCCD). Of these cases reported, 9 people died.METHODS: The objectives of the study were to describe patients who admitted and hospitalized at NCCD and to determineoverall attack rates among health workers, secondary attack rates among students of colleges and universities. Datawas analyzed using Epi-Info2000.RESULTS: Among 929 of laboratory-confirmed cases, 50.3% (95% CI 43.0-57.5) were males aged 23 (±14.9) in averagewith youngest – 7 months, oldest – 76 years old. Data analysis by districts among the hospitalized patients, showed32.8% (139) of total cases in Bayanzurkh district including the first case of the pandemic influenza infection. The majorityof patients who admitted and hospitalized to NCCD mostly experienced fever (288, 68.1%), dry cough (251, 59.3%),headache (203, 48.0%), sore throat (175, 41.6%). With 1020 physicians and health workers in total, 41.4% (422) ofthem work at NCCD, 35.4% (361) – at MCHRC. 11.1% of health workers out of total become ill with pandemic H1N12009 (overall attack rate 11.1%) with the most common symptom, 380C and higher fever (100.0%, 113), sore throat(83.2%, 94), cough (76.1%, 86) and runny nose (59.3%, 67). The higher attack rates of health workers by occupationwere doctor (18.0%) and auxiliary (13%). The secondary attack rates among university students for influenza-likeillness(ILI) were 12.9%. These secondary attack rates were higher among students of art’s college as compared withother universities (52.4%). For students, the main clinical symptoms were fever + sore throat (75.0%, 18), fever+ cough(70.8%, 17).DISCUSSION: In China, as of 27 September, 2009, from reported total 19981 cases infected with pandemic influenza,61.0% were males, mean age was 17, mainly affected with 83% school students that consistent with our study result.The similar results on clinical symptoms were obtained in Russia. Out of 130 patients, 28.6% had 380Ñ and higherfever, for 54.3% the body temperature reached 38.1-390Ñ where as 17.1% - higher 390Ñ and 96% had cough, 89%had muscle ache, 65% had headache, 14% had diarrhea.
5.Comparison results of the population's COVID-19 preventive behaviours
Buuveidulam A ; Suvd S ; Chinzorig B ; Enkhtuya P ; Suvd B ; Dolgorkhand A
Mongolian Medical Sciences 2023;203(1):22-29
Background:
As of September 21, 2021, 65.3 percent of Mongolia's population was vaccinated at full dose. However, as of COVID-19 confirmed cases, Mongolia is in the top five countries in the West Pacific. This indicates that there is a lack of practice to prevention from coronavirus infection in the population.
Goal :
This survey aims to compare the level of knowledge, attitudes, and practices of the population towards coronavirus infection with the results of the baseline survey results
Material and Methods:
This is a cross-sectional study. A total of 1896 people aged 15-60 years old participated in the study. The survey data were collected using quantitative (questionnaire) and qualitative (observation) methods. The research methodology was approved at the Scientific Committee of the National Center for Public Health on November 9, 2021 (Protocol № 5) and the Medical Ethics Review Committee of the Ministry of Health on January 20, 2022 (Resolution №261) was issued the Ethical permission of the survey.
Results:
Out of 14 knowledge questions that should be known about coronavirus infection, survey participants had known in an average of 8.27 ± 3.73 (95%CI: 8.12-8.43) correct answers, which was lower than the results of the baseline study. The average knowledge score of the surveyed participants of the follow-up survey (9.23±3.2, 95%CI: 9.09-9.38) was smaller than the baseline survey by 0.96 percent. 54.5 percent of surveyed participants believed that the pandemic is “very dangerous”. However, it has decreased by 25.6 percent compared to the baseline survey. Positive attitudes toward the right place at the onset of symptoms of COVID-19 and non-discrimination against infected people are more prevalent in a population with a high average knowledge score. In the baseline study, the average duration to wear a mask was 29 hours, while in the follow-up survey, it was 4.2 hours, which shows improvement in the correct behavior.
Conclusions
As the population’s level of education increased, the average knowledge score on the coronavirus infection has increased, and the statistically significant high of the participant with higher education levels was 8.81±3.53 (p=0.0001). In the baseline survey, 64.9 percent of the participants had an attitude toward a discriminant person infected with COVID-19, whereas it was declined by 41.9 percent in the follow-up survey. The practice of wearing masks in crowded places and outdoors were increased by 6.8 percent from the baseline survey. Compared to the baseline survey results, in the follow-up survey, practices of wearing masks in the workplace or indoor environment (73.0%) had increased.