Background Mongolia has been undergoing an epidemiological transition since 1990s. As a result, lifestyle and health behavior related diseases such as cardiovascular diseases, diabetes, cancer and injuries are growing steadily and have become the leading causes of population mortality. According to the Mongolian STEPS Survey on the Prevalence of NCD Risk Factors (2009), the summary of combined NCD risk factors demonstrates that 1 in 5 (26.4%) Mongolian adults have three or more common modifiable NCD risk factors and consumption of alcohol in the past 30 days was reported by 38.6% of the population. Goal The goal of the survey was to determine the prevalence of alcohol consumption among Bugat soum population of Bulgan province. Materials and Methods The cross-sectional survey used a questionnaire of the WHO STEPS survey and adapted it to the local specifics. Alcohol consumption was assessed using the concept of “standard drinks”. A total of 201 randomly selected 15-64 year old residents of both sexes of Bugat soum were involved in the survey. The survey data was collected in September, 2011. The survey data was fully collected using small handled computers (PDAs). Results The survey respondents, 30.3% consisting of males (16.9%) and females (41.2%) were past 12 months abstainers. Of the alcohol users, 69.7% (males 83.1% and females 58.8%) reported drinking during the past 12 months and 47.3% were current drinkers or reported alcohol use during the past 30 days. In contrary, 60.9% of males and 36.8% of females were current drinkers or reported alcohol use during the past 30 days. In terms of the frequency of alcohol use by respondents reporting drinking in the past 12 months, 39.3% drank occasionally, 21.4% drank alcohol for 1-3 days a month, 2.5% drank 1-4 days a week, 4.5% drank 5-6 days a week, and 2.0% reported daily consumption of alcohol. Conclusions The survey results showed that current drinking or consumption of alcohol in the past 30 days was reported by 47.3% in herdsmen of Bugat soum. Of these 60.9% are men and 36.8% are women. As for the quantity of consumption, the current drinkers consumed 13.3 standard drinks for men and 5.0 for women. Frequency of alcohol drinking was higher in males compared to females. The prevalence of binge drinking was 2.5% in men and 0.4% in women, and binge drinking was 6 times more common in males compared to females.

BackgroundTobacco use is responsible for a considerable number of morbidity and mortality in the World. It isconsidered to be one of the main preventable risk factors of non-communicable diseases. The tobaccosmoke contains more than 4000 substances that are harmful to health, and at least 43 of them arecarcinogenic. Globally, there are 1.3 billion smokers and nearly 5 million persons die every year fromtobacco-related illness. Based on current smoking trends, tobacco will soon become the leading causeof death worldwide. Most people begin using tobacco before the age of 18 years. Recent trends nowindicate earlier age of initiation and increasing prevalence of smoking among children and adolescents.In recent years the number of teenagers and women who smoke has grown significantly, with an averageage of initiation of 16 years.MethodsSurvey uses a global standardized methodology that includes a two-stage sample design with schoolsselected proportional to enrollment size. The classrooms within selected schools are chosen randomlyand all students in selected classes are invited to participate in the survey. The survey uses a standardglobal core questionnaire with a set of optional questions that permits adaptation to meet the needsof the country on tobacco use and key tobacco control indicators. A total of 7,298 eligible students ingrades 7-10 completed the survey, of which 6,178 were aged 13-15 years. The overall response rate ofall students surveyed was 92.3%.ResultsA total of 7298 students were covered in the survey. Amongst surveyed schoolchildren, 77.5% werestudents in grades 8-9 and 53.3% were females. 14.3% [95%CI: 4.7-6.7] of surveyed students (n=5775)currently used any tobacco product. Male students were as twice as more likely than female studentsto smoke daily [20.3%, 95%CI: 17.6-23.4 vs. 8.3%, 95%CI: 6.9-10.1]. 15.6% of students were havingever smoked cigarettes. Among those who have ever smoked, 8.6 percent reported to have first triedcigarette smoking before the age of 10-11 years. Male students were more likely to have earlier triedsmoking than female students (р>0.001). The percentage of students who currently use any tobaccoproduct is increased with the student’s age and it was the highest among students aged 15 years oldat 17.8% [95%CI: 15.2-20.8]. 28.6% of all surveyed students, 28.8% of male students and 31.8% offemale students smoked less than one cigarette per day. 37.4% of students smoked one cigarette perday, 25.5% smoked 2-5 cigarettes per day, 3.5% 6-10 cigarettes per day, 1.0% 11-20 cigarettes perday, and 3.9% smoked 20 or more cigarettes per day. 88.6% of those who tried to stop smoking did itbecause they wanted to be healthy. Of the current smokers, 84.3% think that they can stop smoking ifthey wanted to and most of the current smokers never received help or advice when trying to quit stopsmoking.Conclusion:The survey findings would serve as a baseline information database for undertaking a comparativeanalysis of tobacco smoking across the regions of the country; for evaluating of interventions and activitiesfor prevention and control of smoking related diseases; for establishing of surveillance system anddatabase on tobacco smoking; and for implementing of evidence based public health interventions anddecision making. Students had tried to stop smoking and wanted to quit smoking, however, programs,organizations and professionals who can help them to quit smoking are in shortage.

Introduction Worldwide, numerous studies have been conducted and many papers have been published about the impact of climate change on human health, and the correlations between air temperature, precipitation, droughts, and floods, and their adverse health effects such as respiratory and water-borne diseases. Scientific evidence on this issue continues to mount, showing that the effects of climate change are mostly adverse to human health. In Mongolia however, scientific research on the effects of climate change on health is at its starting point and only a few studies have been conducted. Goal Determine and assess risk factors and effects of climate change on human health Materials and Methods The study area included Zavkhan, Selenge, Dornod, Umnugovi aimags (provinces) and Ulaanbaatar city, each representing one of the five climatic zones of Mongolia. Daily meteorological variables for temperature, atmospheric pressure, wind speed, highest wind speed, precipitation and relative humidity of the selected study sites from 2009 to 2011 were acquired from the Institute of Meteorology, Hydrology and Environmental Monitoring. Statistical analysis of the collected data was done using the SPSS18 program and 95%CI was used to determine inter-zonal differences of weather and climatic variables. Results In order to determine climate risk factors, the analysis used the number of days when temperature exceeded mean annual air temperature by +25°С/-25°С, and their sequences, the number of days when the absolute temperature exceeded +30°С in summer months, and -30°С in winter months, and their sequences, the number of days when daily fluctuations in atmospheric pressure exceeded 30 hPa and the number of days when relative humidity was lower than 30 percent or greater than 80 percent, and their percentage of the total number of days.

IntroductionAccording to the World Health Organization (WHO), non-communicable diseases (NCDs) such as cardiovascular diseases (CVDs), diabetes, chronic pulmonary diseases and cancers accounted for 60 percent of mortality in the global population and 80 percent of mortality in low and middle income countries in 2008.Mongolia has been undergoing an epidemiological transition since 1990s. As a result, diseases related to lifestyles and health behavior, such as cardiovascular diseases, diabetes, cancer and injuries are growing steadily and have become the leading causes of population mortality.PurposeTo determine the prevalence of common risk factors for non-communicable diseases among civil servants in Bulgan aimag.Materials and MethodsA total of 300 randomly selected 22-64 years-olds of staff from 9 organizations of Bulgan aimag participated in the study. The prevalence and measures of average distribution of NCD risk factors were estimated.ResultsOut of all participants, 135 were males and 165 were females. Most respondents (96.3%) knew that smoking harms their health. With respect to the frequency of smoking, 15.5 % (95% CI 11.4-19.7) of the respondents were regular smokers, 10.5% (95% CI 6.9-13.9) were irregular smokers and 65.5% (95% CI 60.1-70.9) were non-smokers. 47.1% of the population strongly agreed to the statement that the Mongolians tend to drink too much alcohol at one time and another 47.8% agreed with this judgment. The attitude of the community related to the daily consumption of fruit demonstrated that only 28.2% (95%CI 23.1-33.3) of the respondents considered having fruits daily as “very important” and 58.7%(95%CI 53.1-64.3) considered it as “important”. According to the study results, the prevalence of people engaged in moderate levels of physical activity was 48.5% with significantly more males (60.9%) (95%CI 52.5-69.3) engaged in such activities than females (38.4%) (95%CI 30.9-45.9).Conclusions:1. The samples examined by this study demonstrated a good knowledge on the harms of smoking (96.3%) and second hand smoking (99%).2. The majority of the respondents (94.9%) agreed that the Mongolians tend to drink large amounts of alcohol at once.3. In general, many Bulgan civilians are lack a health promotion attitude in regards of daily consumption of fruits and vegetables, with only about 28.2% of the respondents considering it as very important.

The research on the smoking habits among 8th-to-12th grade students of schools was conducted using a random sampling method among the 13-18 years old school students.Materials and MethodsThe research was performed using a combination of both qualitative and quantitative methods. The quantitative part of the research was performed by conducting surveys among randomly selected secondary school students according to prepared and approved questionnaires. The qualitative study was performed by organizing focus groups based on prepared discussion guidelines. Sampling: the survey participants were students in grades 8-12 from both public and private schools in Ulaanbaatar, the capital city of Mongolia. A total of 1190 students from the 12 secondary schools of 6 districts were selected through random sampling.Resultsto the question of whether the participants have tried to smoke once or twice, 36,1% (407) responded positively. Among these respondents, 49.6% (272) are male and 23.2 (135) are female. This confirms the statistical data that male students are more exposed to the habit of smoking than female students (x2=57.8, p<0.01). The percentage of the currently smoking students is 11.2% (77) of whom 17.9% are male and 4.8% are female. Of the current smokers, 6.8% smoke every day (x2=48.3, p<0.01). The average age of taking up smoking was 14.0[±1.8] of which males students began using tobacco at 13.9[±1.8] years and females at 14.3[±1.6]. Among the smoking students, 10[±2.1]% were from public schools and 17.3[±2.8]% were from private schools (x2=8.1, p<0.01).

BackgroundHuman-induced climate change will affect the lives of most populations in the next decade and beyond. The impact of meteorological conditions on human health has been reported globally. There is a need to conduct surveys for correlation between climate change and human health.GoalTo study the impact of air temperature on human health in selected aimags and city districts.Materials and MethodsIn order to study how climate change and air quality parameters affect human health we selected Zavhan, Selenge, Dornod, and Umnugobi aimags which represent different climate zones and 2 districts of Ulaanbaatar city during 2009-2011. All data for respiratory system disease J00-J99, circulatory system disease I00-I99, were collected from soum, district’s hospital, and aimag and soum’s Department of health.ResultsDuring the study period, a total number of 8649 incidences of respiratory disease are registered. From them 74.2 percent are influenza and pneumonia (J09-J18), 17.6 percent are other acute lower respiratory infections (J20- J22), and 8.2 percent are asthma (J45-J45.9). For cardiovascular disease 15288 incidences are registered. From them 65.6 percent are hypertensive disease (I10-I15), 23.6 percent are ischemic heart disease, and 10.8 percent are cerebrovascular diseases (I60-I69). The lower the air temperature, higher the incidence of influenza and pneumonia, acute lower respiratory infections, hypertensive, and ischemic heart disease.ConclusionsCold weather is correlated with a higher incidence of respiratory and cardiovascular diseases.

BackgroundClimate change, as defined by the United Nations Convention on Climate Change, is a “Change of climate which is attributed directly or indirectly to human activity that alters the composition of the global atmosphere and is observed over time”. In 2001 an Initial Communication on Climate Change was prepared by the Government as part of its obligations under the UNFCCC. One of its recommendations was for “creating public awareness among a wide range of stakeholders including public, private and community sector organizations”. GoalThe main goal of the study was to develop recommendations and measures on prevention from diseases and adaptation to climate change by assessing knowledge, attitude and practice (KAP) of population towards climate change. Based on the main goal the following objectives were setup. Therefore addressing the different levels of knowledge and types of attitudes and practices people have towards climate change must initially be dealt with at the local level where site specific variations can be accounted for. Once research has been undertaken at the local level it can later inform decisions and policy at the regional, continental and global levels on how to incorporate site specific variations with in the greater context of the global threat.Objectives:1. To determine knowledge and attitude of population towards climate change;2. To determine practice of population on some adverse consequences of climate change;3. To develop recommendations and measures on prevention from and adaptation to climate change;Materials and MethodsThe study was at once carried out by means of questionnaire. In order to assess KAP of population, the data was collected using a card with 38 questions in three chapters which previously produced and ratified. The questionnaire was structured into 4 sections; demographics, knowledge, attitudes and practices. Two sums in an aimag from each climate zone of Mongolia were selected. In total, 2258 respondents aged 15 to 64 were involved from eight sums in four aimags (Zavkhan, Selenge, Dornod and Umnugovi), and two districts in Ulaanbaatar. The study data was input to computer using EPIDATA-3.6 software and statistically analyzed using SPSS-18.0 software.ResultsA total of 2258 individuals were interviewed. 44.1% 44.1% (995) of the participants was residents of Ulaanbaatar city and remained percentages accounted for residents living in the center of aimags and soums. 56.7% (1281) of participants were women and 43.3% (977) were men aged with 35.2±15.1 in average. Most of the study participants had educated with medium level (34.8%) and high level (30.0%). Employment percentage is 47.5% (1073). However, most respondents interpreted the meaning of climate change as “a change in weather,” “a change in normal climate conditions,” or “a change in temperature” – answers that requires more common sense than climate change savvy. Global warming is one of the evident of climate change. To know study participants awareness about climate change we used terminology of global warming. 25.3% (571) of the total participants answered that climate change revealed by the overheating or warming earth surface. 42.4% of the respondents answered the climate change could affect to health, 33.2% to environment and 16.3% to economy. 84.5% (1908) of the study participants agreed with that climate change has been started. Most of them (71.3%, 1824) allowed that people’s improper use of nature tend to global warming. When ranging the protection practices during the strong storm means of timbering the houses or gers accounted for 42.5% (960). Study participants supported the following activities; 41.2% (931) agreed that is it necessary to increase health services and 34.1% (769) suggested that it is better to enhance training and propagation for increasing awareness of population about climate change adaptation procedures and some information on climate changes and protection events. 85.2% (1923) of the study participants answered that they want to get the information on climate change from public TV.ConclusionsAlthough knowledge on global warming as the climate change was poor among the respondents, they agreed the climate change has already been started worldwide as well as in Mongolia. Only half of the respondents have had practice to prevent themselves from natural disaster.

Background: Natural protection against Mycobacterium tuberculosis is based on cell-mediated immunity, which most importantly involves CD4+ and CD8+ T-cell subsets. Therefore, the evaluation of CD4+ and CD8+ T-cell profi les are important to evaluate cell-mediated immunity. Immuno-regulating therapy is important in increase of T cell subsets. Objective: To determine some T-cell subsets in active pulmonary tuberculosis patients following immunoregulating treatment in intensive phase of antituberculosis treatment, so to evaluate the treatment effect. Method: This study was conducted in TB clinic of National Center for Communicable Diseases (NCCD) between Aug 2008 and Mar 2009. CD4+ and CD8+-T cells were evaluated in 50 active pulmonary tuberculosis (infi ltrative form) cases before antituberculosis treatment (25 cases with Salimon-Study group, 25 cases without SalimonControl group) Patients with chronic disease, pregnant and alcohol users are excluded. The T cell subsets count was performed by FACSCount fl ow cytometer at the Immunology Laboratory of the NCCD,Mongolia.The monoclonal antibodies to CD3, CD4 and CD8 (Becton Dickinson) were used for the analysis. Result: CD4 count was 605,1242,7 cells/microL, CD8 count-470,92235,7 cells/microL, CD3 count-1130,7425,6 cells/microL, CD4/CD8 ratio was-1,480,67. CD4, CD8, CD3 cells were signifi cantly lower (P=0.05) in active pulmonary TB patients than in healthy Mongolian. And these subsets were signifi cantly lower in older patients (>50 age).There was no statistical signifi cance in sex and other age groups (p>0, 05). There were statistical signifi cances such as CD4 count, CD4/CD8 ratio (CD4-733,95314,38 cells/micro, CD4/CD8 ratio-1.870,7 in treatment group, CD4-570,54213.07 cells/micro, CD4/CD8 ratio-1.260.45 in control group) between TB and control group at the end of intensive phase of antituberculosis treatment (=0,05, =0,001). However, there were not any signifi cance CD8 count and CD3 count between two groups (CD8-423,68174,28 cells/microL, CD3-1212,27453,98 cells/microL in treatment group, CD8-500,67203,74cells/microL, CD3 -1139,33 386,47 cells/ microL in control group) (=0,05). Conclusion: 1. T cell subsets were signifi cantly lower in active,new,smear positive, pulmonary TB patients than in healthy Mongolians (p=0.05). 2. The statistical signifi cance is observed in 50 years and older TB patients (p=0.05). 3. CD4, CD4/CD8 were signifi cantly higher in patients treated with immuno-regulating treatment than in patients of control group (=0,05, =0,001).

The Western Pacific Region have the highest neonatal mortality rate of any country in the world. It has 37 countries and areas with approximately 1.8 billion people which comprises one-fourth of the total world population. The First Embrace It is care for all mothers and newborn infants. The components of the First Embrace are immediate and thorough dying, appropriately timed clamping and cutting of the cord, skin to skin contact and initiating exclusive breastfeeding for all newborns. Aim: First embrace and Early Essential Neonatal Care the importance of infant seeks to to learn some of the problems faced by identifying the skills of medical personnel. We were conducted in this study by a cross sectional questionnaire in order to assess the knowledge, attitude and practices of healthcare providers about essential newborn care and administrated a structured questionnaire to evaluate instruments and materials of the maternity wards.Skin to skin contact and a mother first embrace is the beginning of a healthy life is to reduce the newborn mortality. And the first embrace is improves the children’s immunity. We determined urgent problems for EENC including a lack of maternal health education, inadequate salaries for health care providers, a lack of essential medicines and commodities for birth preparation and numbers of health care providers delivering neonatal intensive care are increased due to the stillbirth rate has increased dramatically year by year.The first embrace is important to reduce neonatal mortality rate and 92.0% of all participants have the enough experiences for the first embrace care and 80.3% of all participants for the EENC.

IntroductionClimate change has already been started in Mongolia. The frequency of natural disaster such as drought, zud disaster, snow storm, hot and cold extreme weather, and earthquake has increased every year. As per daily information of meteorological stations, annual air temperature has been increased since 1960. Children is more sensitive in varies environmental impacts compared with adults and adverse effects caused by climate changes can be remained in all lives and it can be irreversible. Relation between climate change and children’s health is one of the issues which have not been studied yet. The purpose of this study was to investigate relationship between respiratory diseases of children and climate change as well as some air pollution parameters.Materials and MethodsStudy was carried out by cross-sectional study design. According to the regional climate classification of Mongolia, Zavkhan, Selenge, Dornod and Umnugovi provinces was selected as a target area of the study. The relationship between respiratory disease of children and climate change as well as some air pollution parameters were analyzed based on statistical data of Health Departments and Family doctors’ documentation of those provinces for prevalence and incidence of respiratory disease among the children aged 0-16 and daily information of climate parameters such as air temperature, air pressure, relative humidity and precipitation status taken from selected provinces Meteorological Departments and data for air quality basic parameters (SO2, NO2, CO2, PM 10) taken from Air Quality Department of Ulaanbaatar city.ResultsRespiratory diseases among the target ages were registered highly (70.7%) in age of 0-5 years. According to the comparison results in incidence rate of respiratory diseases by region, upper respiratory tract diseases (J09-J18) and lower respiratory tract diseases (J20-J22) were registered in Umnugovi aimag (254.75 and 50.42cases per 10000 children)which belong to very dry and warm regions and Dornod aimag (121.62 and 26.11 cases per 10000 children) which belong to dryish cold regions in 2010. Respiratory tract diseases (J09-J18, J20-J22) were correlated weak indirectly with average air temperature and minimum average air temperature. It was correlated weak directly with wind speed and air pressure. Respiratory tract diseases (J09- J18, J20-J22) were correlated directly with SO2 concentration in air (r=0.269, p>0.001) and NO2 (r=0.286, p>0.001).ConclusionClimate change and air pollution could be influenced on the increase of morbidity of respiratory tract infections. Some air pollution parameters such as SO2, NO2 and PM2.5 and air temperature, air pressure, relative humidity and wind speed are the causes of respiratory tract infections among the children aged 0-16.