1.Childhood cancer in Mongolia: focusing on trend in incidence from 2008 to 2017
Erdenechimeg S ; Undarmaa T ; Oyunchimeg D
Mongolian Medical Sciences 2019;187(1):23-28
Introduction:
An international study coordinated by the International Agency for Research on Cancer (IARC) and published today in The Lancet Oncology shows that in 2001–2010, childhood cancer was 13% more common than in the 1980s, reaching an annual incidence rate of 140 per million children aged 0–14 years worldwide. Cancer incidence and mortality statistics reported by International Cancer Research Center (2016), over 300,000 children develop cancer worldwide each year, 215000 children aged 0-14 years and 85000 children aged 15-19 years. Internationally comparable data on childhood cancer incidence in the past two decades are scarce. Based on the need for comparison of childhood cancer incidence in Mongolia to the global level, the study aimed to categorize cancer among children aged 0-19 years.
Goal:
To study the insidence rates and trend from childhood cancer last 10 year in Mongolia
Materials and Methods:
The study was conducted in 786 new cases childhood who were cancer diagnosed, between 2008 and 2017 year. Age-standardized incidence rates were calculated by the direct method using age-specific incidence rates and weights based on the age distribution of the standard world population
Results:
Over the past 10 years, childhood cancer accounted for 1.5% of total cancer in Mongolia. By WHO and IARC data, worldwide childhood cancer age standardized rate (ASR) is 106.0, in Mongolia childhood cancer ASR (101.6) is lower than world average.
The most common childhood cancers worldwide are: 1st leukemia, 2nd lymphoma, 3rd central nervous system cancer, 4th retinoblastoma, 5th soft tissue cancer. Over the past 10 years the most common childhood cancers in Mongolia are: 1st leukemia, 2nd central nervous system cancer, 3rd joint bone cancer, 4th lymphoma, 5th soft tissue cancer. Our country’s childhood cancer ASR is below compared to other countries, but expected growth rate is gradually increasing (3.0 per year).
Conclusions
1. Leukemia is the most common childhood cancer in worldwide and also in Mongolia.
2. By sex, childhood cancer incidence is higher in boys than girls.
3. By age group, childhood cancer incidence is the highest in 0-4 age group.
4. By region, childhood cancer incidence is the highest in central region.
5. The overall incidence of childhood cancer (1 million children) in Mongolia is expected to increase by 3.0 over the next 5 years.
2.The prevalence and several clinical characteristics of myotonic dystrophy in the population of Mongolia
Baasan D ; Erdenechimeg Y ; Oyungerel B ; Sarantsetseg T ; Khandsuren B ; Chimeglham B
Mongolian Medical Sciences 2011;168(1):23-26
Backgroundв Previous the prevalence of myotonic dystrophy was identified very rare, because of the poor diagnostics. In fact, due to getting high quality of diagnostical equipments the disease is determined very common among people in the world. According to some researchers’s statistical data during 1980-1990 years, the prevalence was 1.1 in England, 2.4 in South Ireland, 5.0 in Switzerland per 100.000 population.Goal. The study was aimed to establish the prevalence of myotonic dystrophy in MongoliaMethod. In this study which is a part of a general epidemiological study of some hereditary neurological diseases in Mongolia since 1997, authors established the prevalence of myotonic dystrophy among 1.7 million population from 14 aimags and the capital city Ulaanbaatar during the period from 1997 to 2010.Results. The prevalence by aimags was ranged from 0.0 to 27.06 per 100.000 population. The average nationwide prevalence is 5.63 per 100.000. Several aimags, especially Gobi-Altai, Orkhon and Khuvsgul are high prevalence with over 3-5 times the average. But in Dornod, Bayan-Ulgii, Dundgobi, Zavkhan, Uvurkhangai, Khentii aimags didn’t have a case of myotonic dystrophy in their population. The rest of aimags have a prevalence from 2.45 (Uvs) to 5.0 (Ulaanbaatar) per 100.000 population.Conclusion1. The relatively high prevalence of myotonic dystrophy was determined among the Mongolian population, especially in Gobi-Altai, Orkhon and Khuvsgul aimags with over 3-5 times the average. 2. The disease is spreading through reproductive way in some isolated populations. There is also a trend of increasing incidence of the disease in urban areas apparently through mechanic way rural to urban migration. 3. The study concludes that there is a need of more intensive response to fight and prevent this disease through upgrading to the modern neurological and genetic diagnostics of the disease, and their regular and sustainable application. Consequently, there is also should be need to create and improve clinical and genetic counseling for patients with this disease.
3.The prevalence of hereditary spastic paraplegia in population of Mongolia
Baasanjav D ; Erdenechimeg Y ; Oyungerel B ; Sarantsetseg T ; Khandsuren B ; Chimeglham B
Mongolian Medical Sciences 2011;168(1):27-30
Background. The prevalence of hereditary spastic paraplegia or Shtrumpel disease is very various in studied countries of the world. It fluctuated between 0.43 (Bulgaria) and 72.4 (South African Republic) per 100’000 population.Method. In this study which is a part of a general epidemiological study of some hereditary neurological diseases in Mongolia since 1997, authors established the prevalence of myotonic dystrophy among 1.7 million population from 14 aimags and the capital city Ulaanbaatar during the period from 1997 to 2010.Goal. The study aimed to establish the prevalence of hereditary spastic paraplegia (HSP) in Mongolia.Material and Method. This study is part of a general study of the epidemiology of hereditary neurological diseases in population of 14 aimags (provinces) and the capital city Ulaanbaatar (the total population covered by the study was 1’738’000) which is being carried out since 1997. The sizes of population in aimags and the city ranged from 47,800 (Southgobi) to 605,292 (Ulaanbaatar). This study report extrapolates the prevalence nationwide. Diagnosis was established by mainly clinical characteristicsResult. Study revealed 47 patients from 15 families. The prevalence of HSP by aimags was established from 0 to 13.48 per 100’000 population (Uvs aimag). The average nationwide prevalence (1’700’000 above) was established at 2.70/100’000. There are revealed 9 cases (19.1%) in ages of 0 and 14, 6 cases (12.8%) in ages of 14-19, 27 cases (57.5%) in ages of 20- 49 and 5 cases (10.6%) in age above 50.Conclusion1. By prevalence of HSP Mongolia belongs to countries with average prevalence. But the prevalence rates differ by aimags. Patients with HSP in Ulaanbaatar (11 cases) were covered by molecule-genetic analysis by types of the disease, revealing occurrences of II and IV subtypes. 2. Of all patients, 90% are below 50 years of age pointing to the early morbidity with this disease in the context of their early mortality. The situation reveals the need of further moleculegenetic and clinical studies of the types of this disease and of improvement of clinical and genetic counseling of HSP patients.
4. STIGMA AND DISCRIMINATION AGAINST PATIENTS WITH ALCOHOLIC DEPENDENCE
Dolgorsuren S ; Erdenechimeg SH ; Gantsetseg T ; Oyunsuren D ; Khishigsuren Z
Innovation 2015;9(1):86-91
Stigmatization and discrimination against mental patients and their family members due to typical community misunderstanding about mental diseases are commonly occurred among population. Particularly, discrimination against alcoholic patients and stigmatization against theirfamily members are most common among Mongolian people, because prevalence of alcohol dependence problems is increased 2 times more in last decades. Our aim was to define current situation of stigmatization and discrimination against alcoholic patients. This survey has been conducted among total 90 inpatients with alcoholic problem, are have staying in National Center for Mental Health and Narcology Center. We conducted the study by descriptive and crossectional design.Totally 90 alcohol patients, aged 19-61 years were participated in our survey. 67 (74.4%) of them were male and 23(25.5%) were female and average age was 40.1±1.1. Level of job’s discriminationwas growingrelated to increasing the level of alcohol consumption (p<0.0016)and level of family’s stigma was growing related to increasing the level of alcohol dependence (p<0.0001). Most of patients (n=29), who are divorced from their couples were answering that main reason of their divorcing was alcohol problem and bad interfamily relationship.Furthermore, stigmatization and discrimination increasing due to increasing level of alcohol consumption (p<0.0001).Most of participants (60%; n=54) are answered, that stigma and discrimination against them were occurring from their family.
5.Structure and prevalence of hereditary neurological diseases in population of some provinces (aimags) of Mongolia
Baasanjav D ; Erdenechimeg YA ; Oyungerel B ; Sarantsetseg T ; Chimeglkham B ; Khandsuren B
Mongolian Medical Sciences 2010;152(2):24-30
BACKGROUND: The study of epidemiology of hereditary neurological diseases in Mongolia began a few years ago. Itcovered a few aimags (provinces) (D.Baasanjav, 2000-2005). Previous studies have shown, that hereditary neurologicaldiseases are not rare in Mongolia and structure and prevalence of these diseases vary by aimags. Mo n g o l i ahas 21 aimags (administrative provinces), each with a population from 45000 till 110440. In some “isolated” populationsspecific neurological hereditary diseases can be marked as “indigenous”. So the epidemiological study of hereditaryneurological diseases in Mongolia is one of the urgent medical shortcoming in Mongolia.MATERIAL AND METHOD: We used descriptive epidemiological method for revealing hereditary neurological diseases infamilies in population of 8 provinces (aimags) of Mongolia, Bayan-Ulgii, Bayankhongor, Govi-Altai, Zavkhan, Dundgobi,Khentii, Orkhon, Uvurkhangai, total of 627,000 population. The population of these aimags fluctuated in the range from47959 (Dundgobi) to 110440 (Uvurkhangai). Diseases were diagnosed by neurologists using clinical and genealogicalmethods.RESULTS: The study revealed 77 patients in 40 families in the studied population with variety of neurological hereditarydiseases. The overall prevalence of hereditary neurological diseases for 100,000 population is 12,26. The prevalencevaries by aimags from 2,08 (Dundgobi) to 32,50 (Gobi-Altai) per 100.000 population. The prevalence and their rangeby nosological structure per 100000 population in aimags are: myotonic dystrophy 5.41 widely varying by aimags: from4.66 in Bayankhongor to 27.09 in Gobi-Altai; Charcot-Marie-Tooth syndrome 1.59 and ranging from 2.08 in Dundgobito 4.66 in Bayankhongor; Duchenne muscular dystrophy -0.79 and ranging from 0.90 in Uvurkhangai to 3.19 in Bayan-Ulgii; the limb girdle muscular dystrophy -0.95 and ranging from 1.81 in Uvurkhangai to 4.66 in Bayan-Ulgii; Strumpellfamilial spastic paraplegia -0.95 for total pop and ranging from 2.71 in Uvurkhangai to 5.41 in Bayankhongor; familialparoxysmal myoplegia -0.79 for total pop. and range from 2.22 in Orkhon to 5.41 in Gobi-Altai; spinocerebellar ataxia -0.47 for total pop. (3.91-in Zavkhan); bulbo-spinal amyotrophy -0.32(only in Bayankhongor); spinal amyotrophy of adults-0.16(only in Uvurkhangai); arthrogryposis with myodystrophy -0.63 (only in Khentii); kyphoscoliosis with myodistrophyand nanism -0.16 (1.06 in Bayan-Ulgii)A comparatively high prevalence of all neurological hereditary diseases per 100.000 pop. was established in Gobi-Altai(32.50), Orkhon-26.56, Bayankhongor-15.16, Bayan-Ulgii -11.70 rates; the low prevalence - in Dundgobi-2.08 and-Zavkhan-3.91.The hereditary neuromuscular diseases among all hereditary neurological diseases taken up 71.9% i.e 55 patients from29 families. The myotonic dystrophy is tops the list of neuromuscular diseases (61.8%)CONCLUSION: Hereditary neurological diseases have a relatively high prevalence among the population of Mongolia,specially the neuromuscular diseases; so the control of these diseases in the country is one of the special priorityproblem of the national health care.
6.Prevalence and clinical characteristic of multiple sclerosis in rural population of Mongolia
Baasanjav D ; Erdenechimeg YA ; Oyungerel B ; Sarantsetseg T ; Chimeglkham B ; Khandsuren B
Mongolian Medical Sciences 2010;152(2):31-36
BACKGROUND: Multiple sclerosis is spreading in population of Mongolia last 30 years. But there are rare of the date ofprevalence of this disease in Mongolia. So we have studied the prevalence of this disease in population of 8 provinces(aimags) of Mongolia in 2008 year.GOAL: To reveal and establish prevalence and clinical characteristic of multiple sclerosis (MS) in population of 8 aimags(provinces) of Mongolia.METHOD: Revealing of patients with multiple sclerosis in population was made by neurologists, which are possessedof clinical method for revealing or confirm the diagnosis and were taken in register the patients only with confirmeddiagnosis. This study was conducted in following 8 aimags of Mongolia: Bayan-Ulgii, Bayankhongor, Gobi-Altai,Dundgobi, Uvurkhangai, Zavkhan, Khentii, and Orkhon; total population of these aimags is 627762 (m-306482, f-321279). The prevalence of this disease was calculated for 100.000 populations.RESULTS: There have been revealed total 35 patients in 8 aimags. The prevalence for 100.000 population is 5,57 (m-2,61; f-8,40) and has been fluctuated in provinces in range from 1,81 (Uvurkhangai aimag) till 13,28 (Khentii aimag) for100 000 population.The rest 6 provinces (aimags) have prevalence in range from 4,17 (Dundgobi) till 6,38 (Bayan-Ulgii).All patients were distributed by clinical characteristic in next main forms:Cerebro-spinal form in 22 patients (62,8%) among them optico-myelitis in 9 cases (40,9%); Spinal form in 6 patients(17,1%); Cerebral form in 4 cases (11,4%); only optical form in 3 cases (8,6%).Pure spinal, cerebral and optic forms are diagnosed in patients, which have duration of disease no more 6-7 years.By the courses of disease all patients distributed in courses the beginning with acute attack incomplete recovery(remissions) revealed in 18 patients (51,4%), more rapid but steadily progressive course in 5 cases (14,3%), acutesevere attacks course in 5 patients (14,3%).CONCLUSION:1. Multiple sclerosis is spreading in population of Mongolia in last 30 years after 1980.2. The prevalence of this disease in population of 8 provinces (aimags) of Mongolia in 2008 year is 5,57 cases (inmen-2,61; in women-8,40) for 100.000 population. The rates of prevalence of the disease by aimags are oscillated inrates from 1,81(Uvurkhangai) till 13,28 (Khentii) for 100.000 population.3. The women suffered more in 3 time than in man and optic form revealed in 34,2 % cases (in 12 patients). Theage of beginning of the disease was fluctuated in age from 16-19 years old till 60 above years old.4. By level of prevalence of this disease Mongolia now is belonging to countries of the world, which have lowprevalence of this disease (till 10 per 100.000 pop).
7.Epidemiology of neurohereditary diseases in the population of some provinces (aimags) existence in south and central part of Mongolia
Baasanjav D ; Erdenechimeg YA ; Chimeglkham B ; Sarantsetseg T ; Oyungerel B ; Bolormaa D
Mongolian Medical Sciences 2014;168(2):12-17
BACKGROUND:Our previous study has shown that the prevalence and structure of the neurohereditary diseaseswere different by provinces and some form of these diseases as “indigenous” in some isolatedpopulation. There are some scientific results of our researches–genetics about consanguineous,which is more potential factor of community is some area of Mongolia. All these circumstance isgiving to carry out this study.MATERIALS AND METHODS:We used descriptive epidemiological method for revealing hereditary neurological diseases in thepopulation of 6 provinces (aimags) of Mongolia: Dornogobi (Easth-gobi), Sukhbaatar, Gobisumber,Central aimag, Bulgan, and Darkhan-Uul. Total population of these provinces is 363072. Thenumber of population in 6 provinces was fluctuated in the range from 15.000 (Govisumber) to 88.875(Darkhan-Uul). Prevalence was accounted for 100.000 populations.RESULTS:The prevalence of neurohereditary diseases makes up 17.08 cases per 100.000 populations amongthese 6 provinces. 79% of these are hereditary neuromuscular diseases i.e 49 patients from 29families. Myotonic dystrophia and genetic neuropathies Charcot-Marie-Tooth have comparativehigh prevalence over test forms of disease.The high rate neurohereditary diseases was established in the population of Bulgan (35.80•10-5),Sukhbaatar (31.17•10-5), and Dornogobi (21.33•10-5) provinces. Their prevalence’s prevailed in the7-10 times over rates Darkhan-Uul, 3-5 times over rates of Gobisumber aimags.No neuromuscular forms of neurohereditary diseases i.e spastic paraplegia (11.3%) andspinocerebeller ataxia (9.68%) accounts for 21% among all forms of neurohereditary diseases.The prevalence of neuromuscular diseases in the population of these six provinces is two times highthen the average rate of the population of Russia (1980 years). First reason is may be associatedwith high predisposition of based on consanguineous through reproductive way in some of theseprovinces of Mongolia.
8.Epidemiology of neurohereditary diseases in the population of some provinces (aimags) existence in south and central part of Mongolia
Baasanjav D ; Erdenechimeg YA ; Chimeglkham B ; Sarantsetseg T ; Oyungerel B ; Bolormaa D
Mongolian Medical Sciences 2013;166(4):15-20
Background: Our previous study has shown that the prevalence and structure of the neurohereditary diseases were different by provinces and some form of these diseases as “indigenous” in some isolated population. There are some scientific results of our researches–genetics about consanguineous, which is more potential factor of community is some area of Mongolia. All these circumstance is giving to carry out this study.Materials and Methods: We used descriptive epidemiological method for revealing hereditary neurological diseases in the population of 6 provinces (aimags) of Mongolia: Dornogobi (Easthgobi), Sukhbaatar, Gobisumber, Central aimag, Bulgan, and Darkhan-Uul. Total population of these provinces is 363072. The number of population in 6 provinces was fluctuated in the range from 15.000 (Govisumber) to 88.875 (Darkhan-Uul). Prevalence was accounted for 100.000 populations.Results: The prevalence of neurohereditary diseases makes up 17.08 cases per 100.000 populations among these 6 provinces. 79% of these are hereditary neuromuscular diseases i.e. 49 patients from 29 families. Miltonic dystrophia and genetic neuropathies Charcot-Marie-Tooth have comparative high prevalence over test forms of disease.The high rate neurohereditary diseases was established in the population of Bulgan (35.80•10-5), Sukhbaatar (31.17•10-5), and Dornogobi (21.33•10-5) provinces. Their prevalence’s prevailed in the 7-10 times over rates Darkhan-Uul, 3-5 times over rates of Gobisumber aimags. No neuromuscular forms of neurohereditary diseases i.e spastic paraplegia (11.3%) and spinocerebeller ataxia (9.68%) accounts for 21% among all forms of neurohereditary diseases. The prevalence of neuromuscular diseases in the population of these six provinces is two times high then the average rate of the population of Russia (1980 years). First reason is may be associated with high predisposition of based on consanguineous through reproductive way in some of these provinces of Mongolia.
9. Malnutrition in the critically ill child
Enkhtsolmon S ; Bayarmaa N ; Malchinkhuu D ; Batsolongo R ; Erdenechimeg T ; Enkhtaivan B ; Gereltuya B
Innovation 2015;9(4):62-64
Children under 5 years of age in developing countries are particularly vulnerable to malnutrition. Malnutrition affects 50% of hospitalized children and 25–70% of the critically ill children. Malnutrition interferes with the appropriate response of the body to disease and predisposes to infection and to the onset of multiorgan failure, increasing morbidity and mortality, the mean length of hospital stay, and health costs. Aim: A prospective cohort study of children admitted to the tertiary pediatric ICU between January 2009 and January 2014 was carried out. To assess the malnutrition type, and impact of nutritional status on outcomes like mortality rate, disease, complication in critically ill children.To the study were enrolled 138 children admitted to the pediatric intensive care units of the NationalCenter for Maternal and Childrens Hospital. The study protocol was approved by the Ethics Committee of the MNUMS, and written informed consent was obtained from all study participants. Nutritional status was determined using Waterlow criteria.Total participants were 49.3% (n=68) of male, 50.7% (n=70) female. 138 children with a mean age 4.4 months ±3.6/ Std.Er/, min = 1 month, max = 12 months, mode = 1 month. n=70(50.7%) acute malnutrition, n=58(42%) chronic malnutrition by Waterlow criteria. In malnutrition group was assessed patient with ricket n=36 (26.1%), patient with anemia n=56(58.9%)While malnutrition is a major problem in pediatric intensive care units. Acute malnutrition moreoccurred in the pediatric intensive care.Malnutrition more occurring of intrauterine infection, genetic disorder, hematology disease’s patients.
10.Current status of Cancer Incidence and Mortality, mean annual 2008-2012 in Mongolia
Undarmaa T ; Tubshingerel S ; Erdenechimeg S ; Badamsuren TS ; Tumurbaatar L
Mongolian Medical Sciences 2016;177(3):25-37
National cancer center of Mongolia has responsibility to produce National cancer registry annual reportwhich is collected cancer reports from primary, secondary and tertiary level of government hospitals andprivate hospitals, laboratories. MCR and indicators of incidence and mortality are important for planningand evaluation of all levels for cancer control, primary prevention, diagnosis, treatment, rehabilitation.ObjectiveThe aim of this study was to determine ASR and ASMRs of cancer incidence and deaths in Mongoliafrom 2008 to 2012 for comparing the results of data.Material and MethodsData on new cancer cases diagnosed in 2008-2012 in permanent residents of Mongolia, collected bycancer registry of the National Cancer Center, were used for the analysis. Incidence and mortality rateswere calculated as mean annual numbers per 100,000 residents. ASRs (Age-standardized incidencerate) and ASMRs (Age-standardized mortality rates) were calculated by the direct method from agespecificincidence and mortality rates, weighted to the World Population standard.ResultsFirst five most frequent cancers (liver, stomach, lung, esophagus, cervix uteri) comprise 76% of all newcancer cases.In males, the most frequent cancer site was liver, followed by stomach, lung, esophageal, colon andrectal cancer. In females, liver is in the first place, followed by stomach, cervical, lung, esophagealcancer.Mean annual crude incidence rate of all cancer sites was 155 per 100 000 population,in males 165, infamale 165 in 2008-2012 years.During this period, mean annual age-standardized incidence rate of all cancer sites was 218,3 per 100000 population, for male 258.9 in female 188.1with higher percentage of men.As we age, morbidity of the cancer increases approximately 2 fold in both sexes and also study revealsmen has more tendency to have cancer than women