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.

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.

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.

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.

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.

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.