1.Current situation of drug-resistant tuberculosis in Mongolia
Naranbat N ; Narantuya J ; Ganzaya S
Mongolian Medical Sciences 2010;153(3):76-77
Since 1994 when Directly Observed Therapy Short Course (DOTS) was first introduced in TB control in Mongolia, the National TB Programme has made significant progress in detecting and curing TB. In 2007, we were able to detect 81% of all TB cases and cure 88%. However, we face many obstacles and challenges in dealing with drug-resistant tuberculosis including limited access to multi-drug resistant TB treatment, limited supply of second-line drugs, limited capacity of service providers, poor infection control in health facilities dealing with MDR-TB patients, limited financial resources. Since 2006 Mongolia has started to implement project on multi-drug resistant TB (MDR-TB) management through support of the Global Fund to Fight AIDS, Tuberculosis and Malaria. In total, 888 cases of drug-resistant TB were detected in our country. Among them, 66.3% (589) were diagnosed with MDR-TB. Among 589 MDR-TB cases diagnosed between 2003-2009, 45.3% (267) are enrolled in treatment, 26.7% (157) died before enrollment into treatment, 19.7% (116) are on waiting list. If we do not improve supply of second-line drugs we will continue to face obstacles in provision of medical services to MDR-TB patients. Our data shows that although MDR-TB cases were diagnosed in 2006, the number of patients who would not be able to receive the treatment and would die by 2015 would increase up to 510 persons. In other words, although about 70 patients are diagnosed every year, they would not be able to receive treatment. Mobilization of 350 thousand US dollars every year and advocacy among decision makers in order to improve their commitment will contribute to fight against MDR-TB in our country.
2.Regional Strategy For Traditional Medicine In The Western Pacific (2011-2020)
Journal of Oriental Medicine 2012;3(2):41-42
In October 2011 Regional Committee meeting endorsed the Regional Strategy for Traditional Medicine in the Western Pacific (2011–2020) which provides guidance for countries and areas, WHO, development partners and other stakeholders on how to maximize the health potential of traditional medicine, and advance the cause of primary health care and universal access to health services for the people of the Region. Strategy advocates inclusion of traditional medicine in the national health system, promotes access and use of safe and effective traditional medicine, encourages protection and sustainable use of traditional medicine resources and supports greater cooperation in generating and sharing traditional medicine knowledge and skills. The Regional Strategy for Traditional Medicine in the Western Pacific (2011–2020) presents a balance between continuity and change, tradition and innovation. Generally, the challenges for the future development of traditional medicine inthe Region are related to framing policy, the development and enforcement of regulatory standards for practice and products, guidance for the assessment of quality, safety and efficacy, education and training, access and equity to traditional medicine products and services, and the safety monitoring of traditional medicine. An overarching challenge for all countries and areas is finding the required financial and human resources to meet these challenges. Therefore in new strategy emphasis has been given to: • the values of primary health care and the contribution of traditional medicine to universal access; • importance of cooperation and the sharing of information to support the quality, safety and efficacy of traditional medicine; and • protection and conservation of indigenous health resources, including traditional knowledge and bio-resources. The complex nature and the interdependence of many of the tasks, and the resources necessary to accomplish the Strategic Objectives for 2011–2020 have been taken into account in framing the directions and actions of the Regional Strategy for Traditional Medicine in the Western Pacific (2011–2020). It is understood that, where and as appropriate, considerations with respect to the implementation of the Strategic Objectives for 2011–2020 will be based on national capacities, locally established priorities, relevant legislation, and on evidence of quality, safety and efficacy. Although the path to implementing the Strategic Objectives will be different in each country and area, where it is helpful, guidance based on groupings of countries facing similar challenges has been provided. It is recommended that, where relevant and appropriate, countries and areas use the Regional Strategy for Traditional Medicine in the Western Pacific (2011–2020) as aframework for the development of specific national traditional medicine programmes. Country-specific strategic plans should be based on the principles of evidence-based traditional medicine and its respectful coexistence with Western medicine. Each country and area is encouraged to carefully select and define a set of indicators to measure progress in implementing the Strategic Objectives which is appropriate for the contemporary and projected status of traditional medicine in their health system. It is intended that the indicators selected by countries and areas will provide useful guidance in decision-making, in identifying needs with respect to requests to WHO, and provide a basis for future planning for the enhancement of traditional medicine. WHO will actively advocate and promote the Strategic Objectives of the Regional Strategy for Traditional Medicine in the Western Pacific (2011–2020) in countries and areas and among development partners and other stakeholders at the regional and country level, in planning and coordinating actions for country support. WHO can play a leading role to support regional initiatives, tailored to the current capacities, capabilities and aspirations of countries and areas, which offer scope for improving and harmonizing standards over time, avoiding duplication, sharing information and facilities, and promoting appropriate mutual recognition arrangements for traditional medicine standards within the Region. WHO will continue to develop source materials for reference or adaptation by countries and areas.
3.Same Result Of Genom Research Of Saussureainvolucrata (Kar Et Kir. Sch.Bip) Growing In Mongolia
Choijamts G ; Azjargal E ; Narantuya S ; Baigalmaa J
Journal of Oriental Medicine 2011;1(1):35-39
Aim and objectives of the study: to establish of NumrugtBanzdoo segment nucleus liner DNA, to observes a nucleus DNA nucleotuds, to constrastBanzdoo of growing in Mongolia. Plant DNA isolated, use amplification of oligonucleotide primers for the Polymerase chain reaction, products were sequenced by Genotec, Inc. From the result to constrast of NumrugtBanzdoo and Banzdoo growing in Mongolia NumrugtBanzdoo is distinct genetical, a like of other NumrugtBanzdoo. NumrugtBanzdoo segment nuclear liner DNA nucleotide sequence information; Length 811bp, Singlestranded weight 248.31 kDa, Double-stranded weight 495.739kDa, Adenine-175, Cytosine-226, Guanine- 243, Thymine-167, ORF-3 (positive-1, negative-2). Now comparative Mongolian’s NumrugtBanzdoo
4.Risk factors of stomach cancer
Unursaikhan S ; Tsegmed S ; Oyundari B ; Sainsanaa Kh ; Narantuya D
Mongolian Medical Sciences 2021;196(2):95-101
Various studies conducted worldwide emphasized the importance of identifying gastric cancer risk
factors for better prevention and further incidence reduction. A total of 52 identified risk factors for
gastric cancer were classified into nine categories in which diet, lifestyle, and infections are leading
causes. Gastric cancer morbidity and mortality has an increasing trend annually in our country. In
Mongolia, only 1% is diagnosed in the carcinoma stage, 3% in the first stage, 11% in the second
stage, 43% in the third stage, 42% in the fourth stage.
The “Gastric cancer risk factors study, 2018” by L.Tulgaa, and D.Ganchimeg confirmed smoking on
an empty stomach as a risk factor. B.Gantuya et al`s (2018) study on gastric cancer and helicobacter
infection, as well as S.Tsegmed et al`s (2012) gastric cancer prevalence, its risk factors study, had
similar results.
B.Gantuya et al (2018) identified the excessive consumption of salt among the gastric cancer
diagnosed population in Mongolia. Also, L.Tulgaa and D.Ganchimeg et al`s “Gastric cancer risk
factors study, 2018” results reported the daily consumption of salt in tea is a risk for gastric cancer.
L.Tulgaa et al`s (2018) study participants had irregular mealtime such as dinners are at a very late
hour, the meals aren`t chewed well, leftover meals, and seasoning consumption. These characteristics
were significantly different in two groups with a statistically important result.
Furthermore, the study results suggested a need to provide practical advice on healthy eating to the
population as 50% of the participants consumed more than 5 high-risk food products for esophageal
and gastric cancer along with combined risk factors.
5.The result of measured household indoor air quality, Ulaanbaatar, 2020
Oyun-Erdene O ; Tsegmed S ; Buuveidulam A ; Bolor B ; Bataa Ch ; Narantuya D ; Suvd B
Mongolian Medical Sciences 2020;194(4):74-83
Introduction:
Beginning 15 May 2019, the consumption of raw coal in Ulaanbaatar has been replaced by the
consumption of briquette fuel for the improvement of air quality according to Governmental Resolution
No.62 adopted in 2018. Since after this resolution has been in placed the number of CO poisoning
has been increased as of 18 December 2019, nine persons were died and 1394 people get a health
care service due to CO poisoning. However, it has been not been assessed briquette affect to the
indoor air quality and its health impact. Thus, it is need urge to define the indoor air quality effect of
briquette and its heath impact.
Goal:
To assess the indoor air quality of the household using the “improved briquette” and identify the
causes of the risk.
Material and Method:
This a cross-sectional survey, conducted from January 31, 2020 to April 31, 2020, data were obtained
by quantitative, qualitative (observation, interview) and direct indoor air quality measurement. The
survey sampling frame was 40 households in central 6 districts of Ulaanbaatar that used improved
fuels (20 households with a history of carbon monoxide poisoning and 20 households that were not
affected), and 14 households in the Nalaikh district that used raw coal, in total of 54 households were
participated. Indoor air quality was measured by PM2.5, PM10, CO, SO2, NO2, and microclimate per
household for 24 hours during a week.
The statistical data analysis was done by the SPSS-23 program and preformed required parametric
and non-parametric tests. The normality of the data was checked by the Kolmogorov-Smirnov test.
The most of data was not normally distributed. So, thus we used median and used relevant non-parametric tests. The average level of microclimate indicators, and air quality indicators were defined
as mean, median and its IQR and standard deviation. The 95% confidence intervals of mean and
frequencies were determined and used to differentiate group differences.
The Ethical permission to start the survey was approved by the 2nd meeting of the Ministry of Health
on February 4, 2020. The committee was reviewed and approved the research methodology based on
whether data collection technique and tools are considered the ethical issues, and whether provided
accurate information for make decisions to enroll to the survey for respondents.
Results:
According to the health statistic, from October 2, 2019 to March 31, 2020, a total of 2,768 people from 837 households were exposed to carbon monoxide poisoning. Of the total reported cases, 10 were
drunk, and 2 were due to other disease complications, and a total of 2,756 cases were confirmed
diagnosis as carbon monoxide poisoning.
Emissions of CO were recorded every 15 seconds and the results were calculated by conducting
continuous measurements per household for 24 hours a week. The level of CO emitted into the
indoor environment of households exposed by carbon monoxide had increased during the following
time from 7 am to 9 am in the morning, from 13 pm to 15 pm, from 18 pm to 20 pm in the evening, and
from 22 pm to 24 pm at night. During this period of time, the indoor air CO level had increased from
the WHO mild poisoning recommendation level.
Conclusion
It has been defined that the carbon monoxide emits to the indoor air households which are using an
improved fuel according to measurement the 30 minutes, 31-60 minutes, and 61-120 minutes after
burning.
6.Study results of the prevalence for thyroid disorders
Tsegmed S ; Norolkhoosuren B ; Otgonbayar S ; Tsientcogzol D ; Lkhagvajav B ; Buanzaya B ; Enkhtuya N ; Anand U ; Bolormaa N ; Narantuya D ; Unursaikhan S
Mongolian Medical Sciences 2022;199(1):15-23
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.
7.Reseach Findings on Certain Physical Characteristics of Adolescents in Bulgan Province
Narantuya S ; Sumberzul N ; Bayarmagnai L ; Amarjargal D ; Davaalkham D
Mongolian Journal of Health Sciences 2025;88(4):105-111
Background:
The development of a country is often measured by the state of human development, especially maternal
and child health indicators. In Mongolia, public health policies targeting the prevention of non-communicable diseases
related to lifestyle and physical development among adolescents are critically needed. However, there is a lack of regional
studies on adolescent health, particularly in rural areas.
Aim:
To study certain physical development indicators among adolescents in Bulgan province.
Materials and Methods:
This analytical study was conducted in 2022 involving 781 twelve-year-old children. Data were
collected from parents and processed using Stata 17.0. Percentages were calculated for qualitative data, and Chi-square
and Fisher’s exact tests were used for statistical analysis. Where statistically significant, multinomial logistic regression
analysis was applied to identify risk factors affecting physical development.
Results:
52.88% of the participants were boys,92.45% lived in traditional or private hous12.04% of the children showed
growth retardation. 49.68% were overweight.70.94% were classified as overweight or obese based on their Body Mass
Index (BMI).Weak muscle strength (1.66%), flexibility (2.05%), endurance (1.66%), and agility (1.92%) were observed.
Boys were more likely to experience height retardation but had stronger muscle strength.Girls showed a higher prevalence
of being overweight.Children living in the provincial center had higher height and BMI, while those in soum centers
demonstrated statistically significant strength in muscle power, flexibility, and endurance.
Conclusion
1. Among the study participants, 70.94% of children were overweight or obese.
2. 1.66% of the study participants had weak muscle strength, 2.05% had weak flexibility, 1.66% had weak endurance,
and 1.92% had weak speed and agility.
3. The use of mobile phones, parental involvement, inactivity, lack of sports, and lack of horse riding have negative
effects on physical development.
8.Results of the evaluation of maternal and child health record keeping
Narantuya S ; Sumberzul N ; Bayarmagnai L ; Amarjargal D ; Davaalkham D
Mongolian Journal of Health Sciences 2025;85(1):232-238
Background:
A particular appealing problem in the medical field of our country is non-communicable diseases, which
are derived from child development and lifestyle, prevention and the decision was approved on being used the maternal
and child health handbook in order to be promptly needed the publicly covered medical policy toward those. Several researchers have noted that in developed countries longitudinal studies are used for checking and controlling in wide range
of epidemic diseases and health issues for maternal and child, pregnancy and postpartum period as well as this method is
directed to be found out multiple information and knowledge.
Not having studied enough how well current situations for postpartum period and maternal and child health in our countryside is become the foundation for our research work. Moreover, it needs to be found out what kind of factors, which
are effected on children who were born to the year of 2010 in Bulgan province, where it started using the first and only
maternal and child health handbook (so called a pink handbook) in Mongolia, health issues. Also, the foundation of this
study was to be needed to focus on our attention to which level of the medical field in order to improve those generations
health issues are improved,
Aim:
to evaluate of a written usage of the maternal and child health handbook, to define its needs, to advertise its results
to the public.
Materials and Methods:
The study is made with a cohort design of an analytical method based on collected information
in 2013, of mothers and children, who are in need, giving birth and being born in 2010 and the results were made on Stata
17 program. The answers were taken with the base study of 2013 from 1015 original case sources within study groups in
needs, and collected information covered with current and actual local situation, as well as to be involved in mothers and
children, who gave birth and were born in 17 sums’ health institutions of Bulgan province.
Results:
Participants age range and educational backgrounds; 70.34 % of mothers were between 20-34 ages, 29.36% of
mothers were 35 and over ages. 1.51% of uneducated mothers, 39.06 % of high school graduates, 49.1% of permanent
residents, 45.38 % of temporary or nomadic or the smallest units residents of administration, 92.08% of married, 39.88%
of families are consisted in members over 5, 52.12% of boys with average weights of 3389.8 grams during the period
of being born, 9.86% of heavy pregnancy or heavy weight fetuses, 4.14% of light weight fetuses or light weight infants.
Plus, the study was defined the mothers educational background to be great and helpful strength to use and record and to
define the usages of the maternal and child health handbook, which was given and thoroughly explained to the mothers
at the beginning.
The leading diseases and their reasons were among three-year aged children, who were covered and recorded with 173
severe burnt, 42 falling injuries from something, 22 being hit and 19 were bitten by animals.
In this study there were 17.83% of participants without the maternal and child health handbooks (pink handbooks),
81.77% of participants carried their pink handbooks with them when they went to the health facilities, 68.47% of them,
who were gotten explanations from the doctors, when the pink handbooks were opened by, 71.72% of participants answered the pink handbooks to be needed. The results of this study have indicated that 71.72% of mothers, who used it at
first time, answered the maternal and child health handbooks were very important and handy for understanding to check
and observe for mothers and children’s development and growth.
Conclusion
It was the leading reason, which was predominantly recorded with cases of burning, falling injuries, hit
and bitten by animals among three-year of children, who were participated in this study. There were high amounts of
respiratory diseases and diarrheas among toddlers. 71.72% of participants considered that the maternal and child health
handbooks were important.
9.Health professional’s knowledge, attitude and practice (KAP) on air pollution
Otgonbayar D ; Tsegmid S ; Suvd B ; Oyun-Erdene O ; Buuveidulam A ; Zolzaya D ; Oyunchimeg D ; Chinzorig B ; Amartuvshin Ts ; Enkhtuya P ; Narantuya D
Mongolian Medical Sciences 2020;193(3):54-58
Introduction:
Soum and family health care centers (primary health care centers) provide public health services to
reduce the negative effects of air pollution on health. In order to decrease the risk factors due to air
pollution, it is crucial for health professionals, who are providing health care services to the public,
to have the knowledge, attitude and practice to give an advice for residents on how to protect their
health from air pollution. The “Air pollution and child health” report from WHO recommended that
responsibility of health professionals must include knowing the latest information on air pollution,
doing a research, spreading the knowledge, educating families and community and learning from
them as well, proposing solutions, and finding a solution for policy developers and decision makers
in other sectors. Therefore, we conducted this survey with purpose to determine the long-term effects
of air pollution on population psychology and lifestyle and to evaluate the level of knowledge, attitude,
and practice of health professionals on how to protect a health from air pollution.
Goal:
Evaluate the level of knowledge, attitude, and practice of health professionals on air pollution.
Material and Methods:
In 2019, this study conducted a cross-sectional design and collected quantitative and qualitative
data. 88.4% of (n=532) health professionals from 48 secondary health care centers (SHCC) and 64
family health care centers (FHCC), which are agents that implement UNICEF project, in Bayanzurkh,
Songinokhairkhan districts and Bayankhongor aimag were participated in the survey.
Results:
97.4% of the participants agreed that air pollution has negative effects on human health. 99.5% of
participants did not know the Mongolian standard for the acceptable level of air pollutant particulate
matter (PM) and 73.1% of all participants did not receive information about air quality index. 82.1% of
participants regularly give prevention advice with the purpose of protecting maternal and child health
from air. The participants who worked for more than 21 years and who are older than 51 years old
were more likely to give advice (p<0.05). As for the reasons for not giving advice about air pollution
for protecting the maternal and child health, 29.2% of participants answered the service time is not
enough, and 22.9% mentioned the lack of knowledge and information. 30.5% (162) of participants were not satisfied with their skill to give an advice on how to protect maternal and child health from
air pollution. 86.8% of participants indicated that they did not receive proper training on air pollution
and prevention from air pollution.
Conclusion
There is a need to provide training and information on how to protect maternal and child health from
air pollution for health professionals.