INTRODUCTION: In the modern medical practice of Mongolia, autoimmune diseases have notbeen diagnosed in its early stage. The autoantibodies are useful in the patient’s early diagnosis,prognosing, and treatment of autoimmune diseases.GOAL: The aim of the study was to compare the prevalence and levels of autoantibodies in theserum of patients with autoimmune diseases.MATERIALS AND METHODS: This patient-based descriptive study involved 144 participants, withconfirmed diagnosis of autoimmune disease and glomerulonephritis (GN). Face to face interviewwas used to obtain necessary information followed by the physical examination and autoantibodies(anti-SS-A/Ro, anti-SS-B/La, anti-SCL-70, c/p-ANCA, anti-GBM, anti-Sm) measured by Enzyme-Linked Immunosorbent Assay (ELISA).RESULTS: The prevalence of anti-SS-A/Ro 38.6%, anti-Sm 25.7%, anti-SS-B/La 8.6%, c-ANCA7.14%, anti-SCL-70 1.4% were positive in autoimmune disease group (secondary GN), theprevalence of anti-SS-A/Ro 6.8%, anti-Sm 2.7%, anti-SS-B/La 2.7%, c-ANCA 1.4% were positivein primary GN group. A higher frequency of anti-SS-A/Ro 66.4%, anti-SS-B/La 22.8%, and anti-Sm38.4% was observed in the SLE group.CONCLUSIONS: Patients with autoimmune disease was significantly higherly younger and female.SLE associated with several auto antibodies (anti-SS-A/Ro, anti-SS-B/La, and anti-Sm) and eachof which are very useful in distinguishing patients with SLE from other autoimmune diseases.

BACKGROUND:Nano is a key technology to bring accelerated development in science, economy and business in 21stcentury. Besides lots of advantages contained in nanoproducts, cytotoxic effects on human and environmentmay occur due to their extreme small size and large surface area and it promotes chemical reaction andactivates reactive oxygen species in the cell. In the last few decades, human and environment exposureof nanomaterials have been increasing, but research papers related to nanomaterial toxicity have beenpoor.GOAL: Determination of nanomaterial toxicity in medical applicationMATERIALS AND METHODS:Totally 21 nanomaterials collected in this study including imported nano-medicines, disinfectantspray, cleaning solution and experimental nanomaterial produced in Mongolia. The particle sizesof nanomaterialswere determined by Cross correlation analysis and X-Ray diffraction analysis, andmutagenicity was determined by Ames test.RESULTS:The particle sizes of nanomaterials in 5 of 21 were measured at the range of 1 – 100nm and 5 of 21nanomaterials were determined as mutagenic by Ames test.CONCLUSION:Ingredients and production methods can be one of causes of nanomaterial toxicity. Therefore, morespecific methods are needed to reveal cytotoxicity of nanomaterials in the future.

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).

Background: High blood pressure is both a cause and a complication of chronic kidney disease. As complication, high blood pressure may develop early during course of chronic kidney disease and is associated with adverse outcomes, in particular faster loss of kidney function and development of cardiovascular disease. The purpose of this study is early detection of chronic kidney disease in patients with hypertension by defining the prevalence of microalbuminuria.Methods: The study population consisted of 169 subjects with a hypertension. Individuals were considered to have hypertension if the blood pressure measured greater than 140/90 mmHg or if they were taking blood pressure lowering medications. Microalbuminuria was defined as 20 mg/l or greater. Results: We are presenting data on 169 subjects :male 38 (22.5%) female 131 (77.5%), average age 51.6±0.89 At screening, 14.8% of all participants were smokers, 62.1 % engaged in low levels of physical activity, 72.8% - were having tea with salt (table1). Microalbuminuria and renal failure, as GFR<60 ml/ min/1.73 m2, were documented in 34.3% and 16.6% of subjects, respectively. There is positive correlation between MAU and increasing-range of blood pressure (table2). Correlation was found between albuminuria and GFR(r= -0.2 p<0.01) and serum creatinine(r=0.31 p<0.01) the regression result has shown that GFR is associated with MAU and serum creatinine (table 3).Conclusions:1. In 34.3% of patient with hypertension was found nephropathies with MAU2. Microalbuminuria is increased with decline of GFR and raise of systolic blood pressure. GFR decline is with the raise of age and serum. It is important to implement in clinical practice screening of MAU hypertensive patients.3. In 2/3 of all screened subjects was found 1 and more risk factors for CVD.

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).

Background: Lead is known for their neurotoxicity and compared to adults, children are more vulnerable to lead exposure. Varieties of diseases are developed by lead induced damage in children, including decreased intelligent quotient and behavioral changes, such as anxiety. In normal condition lead does not exist in children’s blood and this toxic heavy metal enters into human body through respiratory way and accumulates in blood and bone to harm neurodegenerative and urinary systems. Therefore, the present study aimed to investigate whether the emitted lead from recycling factory for lead acid batteries, which is located in 9 km distance from Khonkhor town and 39 km faraway from Ulaanbaatar city with north-east direction, is affecting the intelligence of the local children. Methods: There are 13 children involved in this study and the participants are divided into two groups, including subjects, who live in areas outside (n=10) and within (n=3) the 1000 m region of the factory zone. The blood sampling was collected according to WHO guidelines and lead level in blood was determined by Leadcare instruments at Environmental health and toxicological laboratory of National Center for Public Health. The intelligence analysis was conducted by Raven’s progressive matrices test. And the statistical analysis was performed by SPSS 21 software to assess correlation of blood lead levels and the intelligence among participated children. Results: It is resulted that average lead level for children’s blood samples is 3.1±1.5 ug/dL and which is found beyond the acceptable range in WHO guidelines. The children’s intelligence was assessed by Raven’s colored Progressive Matrices analysis, which is practically accepted in China, which estimated that average intelligence score of participants were 48.3±13.2. According to correlation analysis of age, sex, intelligence and blood lead level, there was a weak positive correlation was found between children’s age and lead level in blood. In contrast, a weak reverse correlation was observed in regarding with sex and blood lead level and intelligence score was weakly reverse correlated with the lead level in children’s blood samples. Conclusions The determined average lead level was 3.1±1.5 ug/dL for blood samples collected from 13 children who involved in this study and the value is found under the WHO guidance value. Furthermore, their average intelligence score was estimated as 48.3±13.2. The comparative analysis shown that intelligence score of 3 children, who lives within 1000 m region of the recycling factory was lower than those who lives in outside region of the factory and have same age.

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.

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.

Introduction: Among the endocrine, nutritional, and metabolic disease and thyroid disorders occupy a significant place. According to the World Health Organization, 8-18% of the world’s population suffer from thyroid disorders. In our country, no research on the prevalence of the disorders has been conducted before, and this research methodology was discussed by the Scientific committee of the National Center for Public Health and was approved by resolution No.156 of the Ethics Committee of the Ministry of Health on 2020. Materials and Methods: In order to determine the prevalence of thyroid disease in the country, we collected the actual number of thyroid disorders registered in 9 districts of the capital city and 330 soums of 21 aimags for a total of 10 years from 2011 to 2020. The prevalence of thyroid disorders was mapped using Arc view and GIS software. Results Endocrine, nutritional and metabolic disease account for 2.3% of all outpatient cases. Endocrine, nutritional, and metabolic disease accounted for an average of 168.3 per 10000 population over the past 10 years, and thyroid disorders accounted for 45 or 26.7% of endocrine, nutritional, and metabolic diseases. Thyroid disorders are highest in people aged 40-49 years.
Thyroid toxicity is the most common type of thyroid disease in Mongolia, accounting for 56.2%, with an average of 17.2 per 10000 population in 2011-2020. However, iodine deficiency-related thyroid disease accounts for 5.5% of all thyroid disorders, with an average of 2.5 per 10000 population in 2011-2020. In 2011, it decreased by 2.2 per 10000 population, and by 2020, it decreased by 0.2 per thousand to 2.0, but in the last 5 years, it has increased by an average of 2.4 per 10,000 population, and in the last 5 years it has increased by 0.2 per thousand, or 2.6 per 10,000 population. Morbidity is high in the Khangai and Central regions.

Introduction: Mongolia’s capital hosts about half the country’s total population, and its air pollution ranks among the highest in the world during winter. Air pollution is linked to reduced fetal growth, preterm birth, low birth weight, impaired cognitive intra-uterine development, impaired cognitive development, and even spontaneous abortion. Antenatal care includes fetal development monitoring, prevention of anemia, immunization against infectious diseases, prevention of sexually transmitted diseases, and any health risk factors such as environmental pollution.
Health care measures for pregnant women and children under one year of age have the potential to be highly effective because they are directly aimed at reducing pneumonia in children. As such, we need to conduct this survey to determine whether pregnant women were satisfied with the information and advice on air pollution prevention provided by health facilities and to take evidence-based measures. Materials and Methods : The survey data were collected using quantitative and qualitative research methods. In this study, a total of 958 pregnant women participated from Songinokhairkhan district, Bayanzurkh district, and Bayankhongor province center. The overall satisfaction of health services is calculated using the three dimensions namely: satisfaction with health service, operation, and environment of the Health Organization. Satisfaction scores were assessed using an even-point scale. These are “Very Dissatisfied-1 point”, “Dissatisfied-2 point”, “Satisfied-3 point”, “Very satisfied-4 point”. The results were calculated after entering the survey data into SPSS-23, creating a database, and performing error control. The research methodology was discussed at the meeting of the Academic Council of the National Center for Public Health on December 25, 2019, and the methodology was approved by the Medical Ethics Committee of the MOH (Stagnant №2). Results : The survey covered 958 pregnant women aged 16-45 in Bayanzurkh district Songinokhairkhan district, and Bayankhongor province. During antenatal care visits, the majority of pregnant women (BZD- 56.9%, SKHD- 68.3%, BKH province - 86.7%) were advised by their health specialists to go outside for fresh air, while women in Ulaanbaatar (BZD- 18.9%, SKHD- 24.7%) received the information and advice at the lowest percentage. Pregnant women in Ulaanbaatar were less involved in air pollution training than in Bayankhongor. Participants in the air pollution prevention training rated it as “satisfied” regardless of location. 37.2% of pregnant women obtained information on protecting their health from air pollution from the board of Family Health Center and 34% from their district health centers. 86.1% of the participants were able to obtain information on air pollution on their own, while 86% of them got information from their family and friends. Conclusion The percentage of pregnant women getting medical advice, training, and information on air pollution prevention from hospitals during their antenatal care visits was the highest in rural areas. Moreover, their level of satisfaction with counseling had been rated as “satisfied”. Pregnant women often seek information on air pollution prevention from non-professional sources, such as their family and friends.