1.Results of the assessment of the laboratory system
Enkhjargal Ts ; Khadkhuu V ; Naran G ; Regzedmaa D ; Dulamjav J
Health Laboratory 2013;2(2):21-25
Rationale:
Effective healthcare starts with an accurate diagnosis, and laboratory plays an important role in this. All health laboratories, be it clinical, animal health, food safety, or environmental health laboratory, contribute to health care and public health security. Therefore, many public health programs are conducting laboratory assessments. The assessment findings can be used for identification of areas in which efforts should be directed in order to strengthen the national laboratory system and health laboratories.
Goal:
The goal of the project was to assess the national laboratory system and health laboratories of Mongolia.
Methods and materials:
Laboratory assessment tool (LAT) developed by WHO was used for the assessment of two areas: 1. strategic organization at the national level, and 2. specific technical capacities at the laboratories level. The national laboratory system was assessed using LAT System questionnaire with the participation of MOH officers, and the assessment of laboratories was conducted using LAT Facility questionnaire with the involvement of laboratories representing public and private sectors, all three levels of urban and rural health care organizations, and clinical and public health areas of laboratory services.
Results:
The strongest areas of the national laboratory system at the policy and regulatory level were “Coordination and management” and “Laboratory information system”. The weaker (below 75%) areas were “Structure and organizations”, “Regulations”, “Infrastructure” and “Human resources”. The insufficient infrastructure score was due to the lack of financing. The main problems detected in the area of Human resources were insufficient financial and organizational support of continuous education of laboratory workers, shortage of trained personnel and incomplete national registration system of laboratory professionals.
The results of the laboratory capacities showed that the assessed laboratories were strong in “Data and information management”, “Specimen collection and handling” and “Consumables and reagents”. The testing performance of most laboratories was excellent but the external quality assurance was not available in some test disciplines. The weaker areas of the laboratories were “Facilities”, “Public health functions” and “Biorisk management”. The module “Organization and management” showed lower score mainly due to insufficient budget. The same was with “Facilities”. Although the general safety management of laboratories was very good, the biosafety component was not incorporated in it.
Conclusions and recommendations:
1.A national regulatory body needs to be established for the registration of all laboratories and laboratory professional staff.
2.Each laboratory should formally designate an appropriately trained Quality manager,
3.Set-up a formal professional development/ continuous education system for laboratory professionals.
4.Develop biosafety policy and implementation plan.
5.Establish a comprehensive national laboratory information management system (LIMS).
2. HEAVY METAL SOIL POLLUTION IN ULAANBAATAR AND ESTIMATES OF HEAVY METALS IN THE HUMAN BODY
Undarmaa E ; Zolboo B ; Enkhjargal G
Innovation 2015;9(3):146-148
Environmental pollution, manufactured cities related to human activities such as soil contaminated by heavy metals pollution is one of the problems of the world’s major cities. Heavy metals are one of the main sources of pollution and the environment through biogeochemical cycles, and stored for a long time in the body of living organisms, poisoning is able to generate a negativeimpact on human health. Ulaanbaatar, 2010, along the main road in 11 point analysis of 22 soil samples from some of the heavy metal pollution in the soil lead levels were within normal limits,but the high concentration of topsoil is defined. A study conducted in 2011, but the average leadconcentration of 47.3 ppm healthy uncontaminated soil that is 3-4 times larger than defined.Heavy metals in the soil pollution, but pollution levels being conducted quarterly study and their sources of research have been identified. Heavy metal contamination of Ulaanbaatar soil andcalculation of the amount of heavy metals enter the body. Specialized inspection agency of Ulaanbaatar cities laboratory analysis conducted, the data used as descriptive research study design, participated in the study. Metropolitan areas in the 80 point balance divided analyzed by standard analysis of soil samples collected in spring and autumn, MNS5850:2008 was assessed by comparison with the standard.The average amount of lead in the soil of Ulaanbaatar 18.09 mg/kg (95%CI 13.7-22.4mg/kg), and cadmium concentration of 1.02 mg/kg (95%CI 0.7-1.3mg/kg), the mercury concentration of0.03 mg/kg (95%CI 0.006-0.05 mg/kg) that “The quality of the soil, and soil pollutants, maximum permissible elements” MNS5850:2008 standards, compared to less than the maximum allowed. Lead in the soil through the ingestion 11.75x10-3 mg/kg/day (95%CI 8.9-14.55x10-3 mg/kg/day) and cadmium 0.66x10-3 mg/kg/day (95%CI 0.45-0.84x10-3 mg/kg/day) of mercury 0.02x10-3 mg/kg/day (95%CI 0.0-0.03x10-3 mg/kg/day), and inhalation of lead 1.06x10-6 mg/m3 (95%CI 0.80-1.32x10-6 mg/m3) and cadmium 0.06x10-6 mg/m3 (95%CI 0.00-0.08x10-6 mg/m3), dermal adsorption lead 2.62x10-6 mg/kg/day (95%CI 1.98-3.24x10-6 mg/kg/day) and cadmium 0.15x10-6 mg/kg/day (95%CI 0.10-0.19x10-6 mg/kg/day) be digestible. Ulaanbaatar soil containing lead, cadmium, mercury, “The quality of the soil, and soil pollutants, maximum permissible elements” MNS5850:2008 compared to less than the maximum permitted levels. Three entry through access to the body of heavy metals in the soil to estimate the amount of mercury and cadmium lead digestive, respiratory and skin is a little more access.
3.The Study of Respiratory System Disease Morbidity and Mortality of Ulaanbaatar City Population
Suvd B ; Enkhjargal A ; Oyunerdene O ; Narantungalag G ; Saijaa N
Mongolian Medical Sciences 2010;151(1):16-20
This survey had conducted for determining respiratory system disease and mortality trend of Ulaanbaatar city population and for developing evidence based recommendations. In accordance with the methodology we had done meta-analysis and statistical analysis on data 2004-2008. For the data analysis we used SPSS and parametric and non-parametric tests were used for determining disease changes and differences of seasonal, age and gender. In recent 5 years, in Ulaanbaatar, respiratory system disease cases are continuously leading 5 leading causes of disease. In 2008, respiratory system disease cases were 865.0 per 10000 populations and it is compare to 2004 increased by 10-30 percent. Children and women are more tend to attend to hospitals due to diseases cases. The survey also revealed that incidence of pneumonia (116.7-145.8 per 10000 populations) was the most visited case from other ICD10 causes of diseases.The mean age of mortality of respiratory system disease was 36.6±31.8 and the oldest age was 101 and the youngest was under 1 year old during 2004-2008 in Ulaanbaatar. During spring season, acute respiratory system disease, chronic bronchitis pneumonia and others respiratory system disease cases were more admitted from the respiratory system disease. Whereas, during autumn season, emphysema, during winter season bronchitis were the leading causes of respiratory system disease admission (x2=33.779, p=0.013).CONCLUSION: The statistics, 2004-2008 in Ulaanbaatar, were showing respiratory system disease trend constantly and continuously increasing. Age, gender and seasonal characteristics were signifi cantly correlated with the respiratory system disease. During these 5 years, 932 deaths were recorded and mean age of dying was 36.6±31.8.
4. Results of the assessment of the laboratory system
Enkhjargal TS ; Khadkhuu V ; Naran G ; Regzedmaa D ; Dulamjav J
Health Laboratory 2013;2(2):21-25
Rationale: Effective healthcare starts with an accurate diagnosis, and laboratory plays an important role in this. All health laboratories, be it clinical, animal health, food safety, or environmental health laboratory, contribute to health care and public health security. Therefore, many public health programs are conducting laboratory assessments. The assessment findings can be used for identification of areas in which efforts should be directed in order to strengthen the national laboratory system and health laboratories.Goal:The goal of the project was to assess the national laboratory system and health laboratories of Mongolia.Methods and materials:Laboratory assessment tool (LAT) developed by WHO was used for the assessment of two areas: 1. strategic organization at the national level, and 2. specific technical capacities at the laboratories level. The national laboratory system was assessed using LAT System questionnaire with the participation of MOH officers, and the assessment of laboratories was conducted using LAT Facility questionnaire with the involvement of laboratories representing public and private sectors, all three levels of urban and rural health care organizations, and clinical and public health areas of laboratory services. Results: The strongest areas of the national laboratory system at the policy and regulatory level were “Coordination and management” and “Laboratory information system”. The weaker (below 75%) areas were “Structure and organizations”, “Regulations”, “Infrastructure” and “Human resources”. The insufficient infrastructure score was due to the lack of financing. The main problems detected in the area of Human resources were insufficient financial and organizational support of continuous education of laboratory workers, shortage of trained personnel and incomplete national registration system of laboratory professionals.The results of the laboratory capacities showed that the assessed laboratories were strong in “Data and information management”, “Specimen collection and handling” and “Consumables and reagents”. The testing performance of most laboratories was excellent but the external quality assurance was not available in some test disciplines. The weaker areas of the laboratories were “Facilities”, “Public health functions” and “Biorisk management”. The module “Organization and management” showed lower score mainly due to insufficient budget. The same was with “Facilities”. Although the general safety management of laboratories was very good, the biosafety component was not incorporated in it.Conclusions and recommendations:1.A national regulatory body needs to be established for the registration of all laboratories and laboratory professional staff.2.Each laboratory should formally designate an appropriately trained Quality manager, 3.Set-up a formal professional development/ continuous education system for laboratory professionals. 4.Develop biosafety policy and implementation plan.5.Establish a comprehensive national laboratory information management system (LIMS).
5.ХАР ЦОХНЫ ЭТАНОЛЫН ХАНДМАЛ ДАХЬ ХИМИЙН ЗАРИМ НЭГДЛИЙГ ТОДОРХОЙЛСОН ДҮН
Dorjjagdag G ; Dagdanbazar B ; Enkhjargal D ; Nyamdorj D
Innovation 2017;11(2):46-48
BACKGROUND. As long ago times or perhaps longer, people were using insects as medicines for healing wounds, preventing infections and improving health. Some of these are purely anecdotal, while others have proven basis in fact as tested by modern medicine.Usage of insects intraditional medicine was recorded since time immemorial.Insects and their substances have been used as medicinal resources by different cultures since ancient time because of chemical compounds - e.g. pheromones, defensive sprays, venoms and toxins, which were sequestered fromplants or prey and later concentrated or transformed for their own use.In many parts of the world,different sections of the society have been using medico-entomological drugs to this day in their lives.A numberof studies has in recent years drawn attention to thetherapeutic value of certain species of insects, their products, and their developmental stages.As has been documented insects can be a source of drugs used in modern medicine, since compounds of insect origin can have immunological, analgesic, antibacterial, diuretic, anaesthetic and anti-rheumatic, antitumor properties. Numerous insect originated materia medicain Mongolian traditional medicine contribute this source of therapeutics and variety of ancientmedical treatises by local authors as well as translations of renowned Ayurvedic medical books about animals as medicine exist.Knowledge about therapy with insects in Mongolian traditional medicine is less studied even they have been used broadly since ancient time. Several orthodox practitioners have surveyed the therapeutic potentials of defensive agents in dark beetleknown as “stink beetle” in the past.Yet the scientific community has to give thismajor and crucial component of traditional Mongolian medicine the attention it deserves, scientific knowledge about biologically active principles within medicinal insect remain poorly unknown.
AIM OF STUDY.To define chemical analysis of ethanol whole body extract of Tenebrionid beetles. METHOD AND RESULT. We collected Tenebrionid beetles from local regions including desert, grassland, and to make an 40% ethanol extract of whole body to determine species of Tenebrionid beetles by entomoscope. After 30 days for saving in organic extract, to determine chemical composition of filtered 2 ml sample solution by high performance liquid chromatography - mass spectrometry (HPLC-MS). Using digital usb microscope 2.0 mp to confirm special characters of Tenebrionid beetles to Tenebrionid B.miliaria in biological termin. In HPLC-MS, octadecanoic acid is presented in 2 regional samples. CONCLUSION. Octadecanoic acid, the surface lipid of the insect was determined from the ethanol whole body extract of Tenebrionid beetles.
6.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.
7.An Overview Study of Air Pollution in Ulaanbaatar City
Ulziikhutag B ; Enkhjargal G ; Buyantushig B ; Jargalsaikhan G ; Eelin Kh ; Ulziimaa D ; Damdindorj B ; Khurelbaatar N ; Davaalkham D
Mongolian Journal of Health Sciences 2025;85(1):263-266
Background:
According to the World Health Organization (WHO), air pollution was responsible for 8.1 million deaths
globally in 2021, making it the second leading cause of death, including among children under 5 years old. Air pollution
is also linked to a range of diseases such as stroke, chronic obstructive pulmonary disease, lung cancer, and asthma. In
Ulaanbaatar, the capital of Mongolia, the average daily concentration of PM2.5 particles in the air reaches 750 μg/m3
during winter, which is 50 times higher than the WHO’s recommendation, making it one of the most polluted cities in
the world. Air pollution continues to pose a significant public health challenge not only in Mongolia but also in many
countries globally. However, there is a lack of comprehensive research and studies that summarize and review the existing
work in this field.
Aim:
To summarize and review thematic works on air pollution conducted by researchers from Mongolian universities.
Materials and Methods:
A systematic review and analysis were performed on thematic works by researchers who completed their master’s and doctoral degrees in the field of air pollution between 2011 and 2024.
Results:
In terms of the type of master’s and doctoral dissertations, 76.0% (n=19) were master’s theses and 24.0% (n=6)
were doctoral dissertations. Among the total number of works included in the study, 36.0% (n=9) focused on the health
effects of air pollution, while 64.0% (n=16) addressed other related areas. Some studies indicated that PM2.5 levels in
the air between 2011 and 2024 were 1-6 times higher than the Mongolian standard, with the highest levels observed from
November to February and the lowest in July. Additionally, some studies suggested a reduction in PM2.5 levels following
the introduction of improved fuel in Ulaanbaatar. Air pollution was found to increase the risk of respiratory and cardiovascular diseases, as well as cancer, and to contribute to reduced fetal weight.
Conclusion
When examining thematic studies on air pollution conducted by state-owned universities in Mongolia, the
primary focus has been on the composition, concentration, and health impacts of air pollution. Going forward, research
aimed at mitigating air pollution should be driven by collaborative efforts and leadership from universities, with the results being effectively communicated to policymakers.
8.Comparison of ambient air PM2.5 pollution in Mongolian cities by raw and improved coal consumption
Buyantushig B ; Enkhjargal G ; Batzorig B ; Ulziihhutag B ; Davaalkham D
Mongolian Journal of Health Sciences 2025;88(4):62-66
Background:
An estimated 99% of the global population lives in environments where PM2.5 levels exceed the WHO air
quality guideline of 15 μg/m³. In 2018, air pollution contributed to approximately 4.2 million deaths worldwide. In Mongolia, air pollution—particularly in urban centers like Ulaanbaatar, worsens significantly during the winter season, posing
a serious public health and local concern. Therefore, it is compulsory to compare the outdoor air quality in Ulaanbaatar,
the capital and Darkhan city.
Aim:
To assess and compare the outdoor PM2.5 concentrations in Ulaanbaatar and Darkhan during the winter season.
Materials and Methods:
This study was conducted in Ulaanbaatar and Darkhan from December 10, 2024, to February
19, 2025. A total of 60 PurpleAir Classic+ sensors (30 per city) were installed to assess PM2.5 concentrations at 2-minute
intervals. We analyzed collected data using R software. The 24-hour average PM2.5 concentrations were compared with
both the Mongolian National Air Quality Standard (MNS4585:2016) and the WHO air quality guidelines (2021).
Results:
The 24-hour average PM2.5 concentration in Ulaanbaatar was 112.3±62.2 μg/m³, which was significantly higher
than that in Darkhan (79.2±25.6 μg/m³; p<0.05). In Ulaanbaatar, the monthly averages were 119.9±67.7 μg/m³ (Decem
ber), 113.5±60.8 μg/m³ (January), and 95.0±51.9 μg/m³ (February) respectively (p<0.05). In contrast, Darkhan city’s
monthly average PM2.5 remained relatively close across the months: 79.1±22.2 μg/m³ (December), 78.7±28.6 μg/m³
(January), and 84.6±30.0 μg/m³ (February), with no statistical significance (p>0.05). During the study period, the 24-hour
average PM2.5 concentrations exceeded the MNS4585:2016 (50 μg/m³) in 69.8% of days in Ulaanbaatar and 64.6% in
Darkhan. WHO’s guideline of 15 μg/m³ was exceeded 93.4% of the time in both cities.
Conclusion
Darkhan city has lower PM2.5 concentrations compared to Ulaanbaatar, both cities significantly exceeded
MNS4585:2016 standard and the WHO air quality guidelines (2021) during the winter months.
9. A study to determine actual daily consumption of drinking and residential water for households in Ulaanbaatar
Zolzaya D ; Suvd B ; Amgalan G ; Tsegmed S ; Bolor B ; Soyombo G ; Oyun-Erdene O ; Altangerel B ; Oyunchimeg D ; Enkhjargal A ; Bolormaa I ; Tsogtbaatar B
Mongolian Medical Sciences 2024;208(2):39-47
Introduction :
Water is a vital resource for human existence and is essential for daily food processing, preparation,
washing, hygiene, and sanitation. Furthermore, providing the population with safe drinking water is one
of the pressing problems of the world and some regions.
In recent years, population density and the scale of commercial and industrial activities, as well as clean
and dirty water consumption were increased in the capital city. As a result of these, ground and surface
water resources are becoming scarce and polluted.
Therefore, assessment of daily drinking and residential water consumption of Ulaanbaatar should be
determined to use drinking water properly in daily life and water loss. This study assessed the actual
amount of households’ daily water consumption.
Goal:
The purpose of this study is to determine the daily consumption of drinking water for households in ger
areas and apartments in Ulaanbaatar.
Materials and Method:
This study covers 30 households in ger areas and 15 apartment households, in Ulaanbaatar.
Household members performed 6-10 types of measurements every day, within 7 days. As a result of
these measurements, actual consumption of water quantity used for drinking and household purposes
was calculated. Statistical analysis was done by SPSS Version 21 to calculate the true probability of
difference between parameters.
Result:
67.9% of the households in the ger areas were 4-5 family members. The average daily household
consumption of drinking and domestic water were 68.3 ± 3.57 L (95% 61.3-75.3), the minimum
consumption was 12 L, and the maximum was 227 L. Average of the household water consumption
water was 97.6-108.9 liters during the weekends, and water consumption was statistically higher than
weekdays (p=0.001; p=0.01).
The water consumption of residential households with 3 family members accounted for the majority
(30.8%) in this study. The average daily consumption of drinking and domestic water was 297.67±19.7
liters. There was no statistically significant difference (p=0.96) in week. The average daily water
consumption including drinking and residential was 270.3-335.97 L.
The total daily drinking and residential water consumption per person was 15.57 L for households in ger areas and 90 L for apartment households. Calculating the daily water consumption of households in ger areas, 60.3% of it is used for laundry, washing dishes, food preparation, washing face and hands, and clothes, 31% for drinking, and 8.7% for outdoor water use. While apartment households, approximately 94.1%, were used for household and 5.9% for drinking purposes.
Research ethics approval :
This study was discussed at the meeting of the Academic Council of the National Center for Public
Health. In addition, this study was carried out according to the methods and methods discussed and
approved at the meeting of the Medical Ethics Control Committee of the Ministry of Health (Resolution
No. 08).
Conclusion
The total daily consumption of drinking and residential water per person were 15.57 litres for the
households in the ger areas and 90 litres for the apartment households. It implies that it does not exceed
the WHO recommendations
10.A Comparative Study of Traditional And Conventional Treatment Of Chronic Pyelonephritis
Enkhbayar M ; Enkhjargal D ; Amarzaya D ; Sarantsetseg G ; Burmaa B ; Munkhzul D ; Khishigjargal S
Journal of Oriental Medicine 2012;3(2):8-8
Abstract The aim of this study is to compare the effects of traditional and conventional treatment of chronic pyelonephritis. Total of 100 patients diagnosed with chronic pyelonephritis were enrolled in the study. Traditional medicines included following: Sugmel-10, Sarichun, Yuna-4, Sema-3, and Sojid-11. Conventional medicines included following: ciprofloxacin, cefasolin, and negram. After 10-14 days of treatment questionnaire, physical examinations, and laboratory tests were performed. In 90% of patient treated with traditional medicines, changes of smell and color of urine was disappeared. Back pain and dysuria was reduced in 89.7% and 75% of patients respectively. While in control or conventional treatment group, changes of smell and color of urine was completely disappeared and back pain and dysuria was reduced in 80% and 88% of patients respectively. Pasternatskii’s symptom and arterial hypertension was reduced in about 58% and 77% of patients respectively. Bacterial growth (Escherichia coli and Staphylococcus aureus) was ceased in 39.4% and reduced in 46.4% of patients treated with traditional medicines. It was ceased in 60% and reduced in 30% of control patients.Traditional medicines reduced signs and symptoms of chronic pyelonephritis. Bacterial growth was ceased or reduced by traditional treatment. Traditional medicines are effective as conventional medicines for treatment of chronic pyelonephritis.