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.