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.

IntroductionIsolated systolic hypertension (ISH) has been found to increase the risk of stroke and coronary heart disease significantly among both middle-aged and elderly men and women. ISH is a higher risk factor for cardiovascular diseases (CVDs) than isolated diastolic hypertension. Because of this it is important to determine the prevalence of ISH and its associated risk factors in order to reduce CVD mortality and morbidity in Mongolia.ObjectivesThe aim of the study was to compare the physical activity of people with ISH to it of people with normal blood pressure (BP).Мaterials and MethodsWe examined the physical activity using the data of “Mongolian STEPS Survey on the Prevalence of Noncommunicable Disease and Injury Risk Factors-2009”. ISH was defined as systolic BP≥140 mmHg and diastolic BP<90 mmHg. The Control (normotensive) group comprised subjects whose systolic BP<140 mmHg and diastolic BP<90 mmHg. Using to approach of WHO “STEPS” Survey, physical activity was assessed on intensity, duration and frequency of physical activity at work, in recreational settings and during transportation using complex set of 16 questions.ResultsAccording to the survey results, 74% of people who had normal BP and 48.7% of people with ISH engaged in moderate levels of physical activity in recreational settings daily a week. It was statistically difference in two groups. Males with ISH were more likely to engage in high levels of physical activity at work and in recreational settings compared to females. In terms of age differences, moderate and high levels of physical activity at work decreased steadily with age. Mean duration and frequency of physical activity a week weren”t difference in two groups.ConclusionFrequency of physical activity decreased with age in respondents with Isolated systolic hypertension. Males engaged more in high levels of physical activity at work and in recreational settings more than females. Moderate levels of physical activity in recreational settings was lower in respondents with ISH compared to respondents who had normal blood pressure (p<0.05).

Introduction: It has been found that morphological changes of elastic and elastic-muscular arteries wall are the main role in elevation of systolic blood pressure. Furthermore, Isolated systolic hypertension (ISH) has been found that to be associated with cerebral stroke, myocardial infarction and heart failure. And according to national study of prevalence of risk factors on non-communicable disease, it found that risk of CVDs (cardiovascular diseases) is a high among Mongolian and one fifth has more than 3 risk factors of atherosclerosis. The researchers found that atherosclerosis begins relative in young people and endothelial dysfunction is without clinical signs of CVD among Mongolian. Purpose : To determine the atherosclerotic changes and associated with some risk factors of subjects with Isolated systolic hypertension. Materials and Methods: We used hospital-based cross-sectional study design. Data collection was conducted using questionnaire, body measurement, and laboratory methods. A standardized questionnaire was used according to the methodology from the “STEPs” Survey on the prevalence of Non-communicable disease and injury risk factors, body weight, height and blood pressure were measured by standard method. Results : In group with ISH, maximal IMT of CCA was 1.46±0.44mm, systolic diameter was 5.89±0.68mm, diastolic diameter was 6.34±0.73mm respectively which were significantly higher than normotensive group (1.21±0.28mm, 5.58±0.59mm, 5.99±0.58mm) (p<0.05). Furthermore we studied plaques of carotid artery, and atherosclerotic plaques were revealed in 69.2 percent of subjects with ISH which was significantly higher compared with normotensive subjects (p=0.003). And resistive, pulsative and stiffness indexes were significantly higher in group with ISH which represents vascular resistance of CCA. But end-diastolic velocity of CCA significantly reduced in group with ISH (p=0.015). We found that atherosclerotic index increases every year by 6.5 percent, every one mm Hg of systolic blood pressure by 3.7 percent and every year of increasing blood pressure by 10.5 percent respectively. Conclusion
1. Atherosclerotic changes were revealed more in subjects with ISH compared to subjects with normotensive.
2. Advancing age, long duration of smoking, a high level of systolic blood pressure, having a high systolic blood pressure level for a long time and high consumption of salt intake are accelerating atherosclerotic changes of carotid artery.
3. According to increasing atherosclerotic change, blood stream velocity of carotid artery is decreasing and resistive and pulsative indexes are increasing.