1.Results of analysis of reporting form of the new registered cases of tuberculosis
Mongolian Medical Sciences 2010;152(2):53-57
BACKGROUND:Tuberculosis is still an important infectious disease today. The resent World Health Organization TB Fact Sheet statesthat it kills approximately 2 million people each year. WHO estimated that between the years 2002 and 2020 inclusive,approximately 1000 million people will be newly infected. According to the fact sheet over the same period, more than150 million people will become infected, and 36 million will be die due to tuberculosis, if control of the diseases is furthernot strengthened.1In 2009, there were registered 4218 tuberculosis new cases in Mongolia. Among them 1809 cases were smear positivepulmonary cases. Mongolia has the 7th highest tuberculosis case rate country in the WHO.WPR.2GOAL: To review “Reporting Form” of the new registered cases of tuberculosis in Mongolia (2007-2009).OBJECTIVES:1. Evaluation how correct fills out of the “Reporting Form”–s of new registered cases tuberculosis.2. Social and professionals status of tuberculosis cases in Mongolia.MATERIALS AND METHODS:We conducted a retrospective study of 10237 Reporting Form of new case of TB. Which are cases reported from 21aimags and 9 districts of Ulaanbaatar city to the Tuberculosis Department of NCCD, between 2007 and 2009.Retrospective analysis for the “line list of tempore office leave’s” among health care works in National Center forCommunicable DiseasesRESULTS:10237 (79%) out of 12802 new TB cases were correct fill out new cases Reporting Forms in 2007-2009In 2007-2009, there were 43.3 %( 4436) unemployed people, 9.7% (994) students, 8.8 %( 901) pupils, 7.0 %( 712)pensionaries of all registered cases. A total cases 18.5 percentage was students.Also 111 health care workers were developed TB throughout country and it is 1.1% of total cases. A total cases of Healthcare workers; 30.6% (34) nurses, 28 %( 31) doctors, 15.3 %( 17) house keepers, nurses are most affected TB fromhealth care workers. Doctor’s who are working in TB and the judicial department, surgeons, dentists, center to recoverthe alcoholic, soum and family practitioners are most affected compared other doctors.CONCLUSION:1. In 2007-2009, there were 43.3% unemployed people, 9.7% students, 8.8% pupils, 7.0% pensionaries, 1.1%health care workers of all registered cases.2. Excepting students TB rate is 18.5% and this rate increasing year by year. We need to more study and analysisof students TB cases and need to planning further intervention among students3. Among health care workers who are working in tuberculosis hospital more risk of get infected tuberculosis.Urgent needs to improve the infection control intervention in the TB hospital and clinics, branch offices, whichhave high risk of infection.
2.Occupational risk factor of health care workers of Hepatitis B infection and its prevention
Naranzul N ; Enkhjargal A ; Тumurbat B ; Tselmeg M ; Nandintsetseg Ts ; Tserendavaa E ; Baatarkhuu O ; Burmaajav B
Mongolian Medical Sciences 2020;191(1):87-95
Hepatitis B (HBV) and C (HCV) are viral infections which can cause acute and chronic hepatitis
and are the leading causes for hepatic cirrhosis and cancer, thus creating a significant burden to
healthcare systems due to the high morbidity/mortality and costs of treatment. The risk of HBV
infection in an unvaccinated person from a single HBV-infected needle stick injury ranges from 6–30.
The prevention of HBV infection among HCWs has become a crucial issue. HBV can effectively be
prevented by vaccination. A safe and effective HBV vaccine has been available since the 1980s and
can prevent acute and chronic infection with an estimated effectivity of 95%. In 2017, the São Paulo
Declaration on Hepatitis was launched at the World Hepatitis Summit 2017, calling upon governments
to include hepatitis B vaccines for HCWs in national immunization programs. The vaccine is 95%
effective in preventing infection and its chronic consequences and has an outstanding record of
safety and effectiveness. Data on current hepatitis B vaccine coverage among HCWs in Mongolia
is scarce. According to Azzaya et al, the protection level of the subjects was 67.2% >100 mIU/ml,
18.8%, 11-100 mIU/mL and 14.1%, 0-10 mIU/mL based on antibody titer level respectively among the
vaccinated HCWs at the 2nd Central hospital. Thus, the HBV vaccination among public and private
sector HCWs in Mongolia to inform the health authorities about the HCWs HBV vaccination status
along with associated problems and challenges for further improving vaccination strategy among
HCWs.
3.Gene mutation associated with drug resistance in M.tuberculosis strains isolated from national TB prevalence survey in Mongolia
Tsetsegtuya B ; Baasansuren E ; Oyuntuya T ; Tserelmaa B ; Gundsuren Sh ; Tsolmon B ; Naranbat N ; Tsatsralt-Od B ; Buyankhishig B ; Naranzul D
Mongolian Medical Sciences 2019;187(1):3-10
Background:
According to the First National Tuberculosis (TB) Prevalence Survey in Mongolia the prevalence of
bacteriologically-confirmed pulmonary TB among adults was 559.6 (95% CI: 454.5–664.7) per 100000
population in 2014–2015. This was three times as high as previously estimated. Nationwide anti-tuberculosis (TB) drug resistance survey was conducted in 1999 and 2007 in Mongolia. Share of multidrug resistant TB (MDR-TB) cases among newly notified TB cases increased from 1.0% in 1999 to 1.4% in 2007. Accordingly, we aimed to perform drug susceptibility test on strains isolated from TB Prevalence Survey and to determine the prevalence of drug resistant TB.
Material and Methods:
All 242 MTB strains isolated from the survey TB cases were tested GenoTypeMTBDRplus test and conventional 1st line DST on solid medium.
Result:
Conventional DST and GenoTypeMTBDRplus tests done for 93.8% (227/242) of them and 6.2% (15/242) were tested by GenoTypeMTBDRplus only. A 61.6% (95%CI 55.3-67.4) of all cases were susceptible to first line anti-TB drugs, any drug resistance and MDR-TBdetected as 38.4% (95% CI 32.5-44.7)and 9.5% (95% CI 6.4-13.9), respectively. Prevalence of MDR-TB was7.8% (95% CI 4.9-12.4) among new and 17.9% (95% CI 9.0-32.7) among previously treated cases. The 64 strains were identified as a resistant to isoniazid, 32.8% (42/64) and 65.6% (21/64) were katG, and inhAmutation, respectively. One isolate (1.6%) was mutations in both the inhAand katGgenes.The predominant mutations detected in therpoB were S531L (91.3%) among rifampicin resistant isolates and the mutation in inhAwas C–15T (100%) and katG mutation was S315T1 (100%) among isoniazid-resistant isolates.
Conclusion
Prevalence of cases with DR-TB is high among prevalent TB cases, especially prevalence of MDR-TB among new cases. In comparison to previous studies, DR-TB cases seem to be increased. Rifampicin resistant strains have a mutation of the rpoBand resistance to isoniazid is predominantly associated with the inhA mutation.