Introduction. Malnutrition has a negative impact on the physical and intellectual development which can further affect health, living potentials and the quality of life. A lack of a sustained decrease in low birth weight and young child malnutrition is associated with the failure to provide nutritious food in adequate quantities to pregnant and breastfeeding women and children up to two years of age. The most recent estimate from the 2005 MICS survey of the prevalence of wasting is 2.8 percent, stunting is 26.8 percent, and underweight is 7.4 percent among children aged 0-59 months in Mongolia.Goal. To assess the current nutritional status of 0-59 months old children of Mongolia, and identify next steps to improve child nutrition.Materials and Methods. This cross-sectional survey was conducted in 21 aimags of 4 economic regions of the country and in the city Ulaanbaatar. A total of 706 children aged 0-59 months were selected from sampled households. Interviews, anthropometric measurements and clinical examinations were used in the survey.Results. The distribution of length/height-for-age Z-scores of the surveyed children was shifted to the left compared to the WHO Child Growth Standard. The weighted average z-score and its standard deviation was 0.78±1.5, which is characteristic of high proportion of "short" children in Mongolia. Of the surveyed children, 15.6% (95%CI 12.7¬18.9) were stunted about one-third of stunted children had severe stunting. The prevalence of stunting was highest in the Western Region, the differences between this region and all other regions were statistically significant. Rural children had statistically significantly prevalence rates of overall stunting, moderate stunting, and severe stunting compared to their urban counterparts. Underweight and stunting were much more prevalent in children who had a low birth weight. Of those with a low birth weight, 35.5% (95%C118.4- 57.3) were underweight and 54.1% (95%CI 35.3-71.8) stunted, but there were no wasted children.Conclusions:1. In rural area the prevalence of stunting among in 0-59 months old children was highest than urban area's children.2. The prevalence of stunting was highest in the Western Region and remains at "high" level according to WHO classification.3. Underweight and stunting were much more prevalent in children who had a low birth weight4. The high rate of stunting among under five year olds is likely related to dietary behavior, and requires further study and intervention efforts.

Justification: Iodine is a micronutrient essential for human health. 92% of the required iodine human organism obtains with food. One of methods to supply the required amount of iodine is the use of iodised salt. The overall goal of our study was to determine the actual consumption of iodised salt by households. Materials and Methods: Samples of salt consumed by 20173 households from five regions (Western, Mountainous, Central, Eastern regions and Ulaanbaatar city) of Mongolia were collected and their iodine contents were determined according to MNS 5168:2002. Results: Out of the total analyzed salt samples, 19.1 % were non-iodised, 2.8% had low iodine content, 77.5% had appropriate level of iodine and 0.6% had high level of iodine.
When the salt iodine contents were evaluated by the country regions, it was revealed that the households in Western (31.4%) and Mountainous (20.57%) regions consumed salt that was not iodised. 84.5% of the Ulaanbaatar city households consumed salt with appropriate level of iodine. Conclusions
1. 19.1 % of the surveyed households consume non-iodised salt, 2.8% consume salt with low iodine content, 77.5% consume salt with appropriate level of iodine and 0.6% consume salt with high level of iodine.
2. The iodine level is appropriate in 84.5% of salt consumed by Ulaanbaatar city households.

BackgroundThere are 137 soums of 17 provinces have plague foci in Mongolia. The 51.7% of them is case, 23.4%- low, 9.5% - high, 0.7% - hyper active. Main host of plague foci is marmot in Mongolia. According last20 year’s surveillance study, about 75.5% of Y.pestis was isolated from marmot, marmot carcassesand their flea. Human plague cases has been caused illegal hunting marmot in Mongolia. Even legaldocument which prohibited marmot hunting was appeared since 2005, people has been hunting marmotfor selling marmot meat, skin and other products. It is depends economy crises and other public issues inMongolia. Also influenced increase risk of human plague and being reverse result in plague preventionactivities.Materials and MethodsStudy was used data of rodent for zoonotic diseases suspicious which tested plague in National centerfor zoonotic disease (NCZD) in 2005-2015 and 13 local center for zoonotic diseases in 1988-2015. Datawas kept in NCZD and National archival authority. For mapping we used Arc View 3.2.ResultsTotally 397 event information of suspicious rodents and other animals was received in NCZD from 8 districtsof Ulaanbaatar city in 2002-2015. Most of information was received from Songinokhairkhan-64.2%district and smallest number was from Nalaikh district-0.3%. 92.2% of them were marmot, 0.1% of themwere marmot raw products for treatment purpose. Totally 1285 animal samples were tested by plaguedisease and the result was negative. Five hundred thirty tree marmots were carried to Ulaanbaatar from10 provinces. In that time plague foci were active and Y.pestis was isolated in provinces which marmotwas carried to Ulaanbaatar.In 1988-2015, totally 257 marmots and animals of 515 event information was received in15 provinces.Including 13.2% of them were birds, 84% of them marmot, 1.6% of them were livestock, 1.2% of themother animals. About 216 marmots were tested by plague. 51.2% of them were detected positive results.We develop conclusion based laboratory investigation result even it need high cost to take earlyprevention and response measures.Conclusion1. It is high risk to spread plague by carrying suspicious animal in urban area. Therefore, it is importantto take early response measures even it high cost. In further, increase cost and support rapid test ofhigh technology.2. To organize rational advertisement and increase knowledge of population about not doing illegalhunting, not selling marmot raw products in urban area, not using marmot raw products for treatmentuse and avoid contact with marmot carcasses.3. It is important to cooperate joint response measures with policeman, inspection agency andveterinary and human health sectors in Mongolia.

Нойр булчирхайн цочмог үрэвсэл, эмнэлзүйн урьдчилан тооцоолох дүрэм, Ranson –ийн шалгуур, APACHE II-ийн шалгуур A clinical prediction rule is a type of medical research study in which researchers try to identify the best combination of medical sign, symptoms, and other findings in predicting the probability of a specific disease or outcome. More than 80% of all patients with acute pancreatitis recover promptly without developing severe pancreatitis. The presence of early organ failure (within 24 hours of admission), multiple-organ system failure, and persistent or progressive (present beyond 48 hours after admission) organ failure are associated with prolonged hospitalization, ICU admission, need for surgery, and death. In high developed country, Ranson and APACHE II prognostic criteria are used in order to evaluate patient´s situation and modified treatment tactics. That is give an idea us to carry out retrospective study, by using patients´ documents, who hospitalized in National central hospital in last year. As result, according to Ranson´s criteria 13 (31.7%) of all patients had 0-2 score, which means mortality risk was 1.8%, 20 (48.8%) had 3-4 score (mortality risk is 11%), 8 (19.5%) were estimated 5-6 score, having 33% of mortality risk. Whereas, regarding to APACHE-II criteria 14 (34.2%) of total patients had score of 0-4, showing 4% of mortality risk, 23 (56.1%) were scored 5-9, having 8% of risk, 3 (7.3%) were scored 10-14, having 15% of risk, 1 (2.4%) had 15-19 score, having 24% of risk. Moreover, we determined that incomplete laboratory test, meaning essential prognostic criteria not used in Mongolia.

Background: Oral candidiasis, which is one of the most common diseases of the mucous membrane, is carried in the mouth of about 17-75% of healthy population. And 51-74% of this healthy population is asymptomatic. However, oral candidiasis is found in 50-65% of the individuals with dentures, is found in 67% of elders over 75 years old and is found in 85% of the patients with oral cancer. The most common causative organism is C.albicans with 43.7%, less commonly C.glabrata and C.tropicalis. According to some researches, the occurrence of the oral candidiasis has been increasing continuously for last 20-30 years, and has strong tendency to consistently increase for the 21st century. Methods: Total 50 patients were participated in this study, including; the patients with full denture from Department of Prosthodontics of The Dental Center of Ulaanbaatar, and patients with evident symptoms of candidiasis from Department of Neck and Head Surgery and Department of Radiation Therapy of National Cancer Center of Mongolia. The study was carried out by descriptive study type, based on the patients’ questionnaire survey, physical examination and laboratory tests. Results: The oral candidiasis causing pathogen Candida was found in 100% of following patients including; the patients with full denture and the patients having head and neck radiation therapy. For the patients with full denture, Candida albicans was the most commonly implicated organism with 53%, Candida tropicalis 21% and Candida krusei 11%. For the patients with radiation therapy for head and neck cancer, most common pathogen was Candida albicans with 64% and Candida tropicalis with 7%. Conclusions Main causative pathogens for the patients with full denture are C.albicans (53%), С.tropicalis (21%), and for the patients with radiotherapy for head and neck cancer is C. albicans (64%). 95% of the participants who were diagnosed with oral candidiasis were resistant to Colistin and 100% sensitive to Nystatin and Miconazole.

Background: Weight at birth is a good indicator of the mother’s health and nutrition status during gestation and a child’s chances for survival, growth, long-term health, and psychosocial development. Low birth weight (defined as less than 2500 grams) poses a range of serious health risks for children. Objective: To assess the prevalence of low birth weights (LBW). Materials and Methods: The NNS V was implemented in 21 provinces (aimags) in 4 economic regions (Central, Eastern, Khangai, Western) and the capital city of Ulaanbaatar. A total of 2250 children aged 0-59 months. Given the regional differences in lifestyle and nutrition status, target populations were stratified into 5 strata based on economic region and Ulaanbaatar with equal samples drawn from each stratum using a cluster-randomized sampling design. For the selection of households in urban areas, the process involved first selecting 30 khoroos (clusters), then khesegs, and then households with a child 0-59 months of age. Ethical considerations : The survey methodology was discussed at the Scientific Committee of the Public Health Institute (recently named by National Center for Public Health) and granted the PHI Directors Order on 28th June, 2016. Ethics approval for conducting the NNS V, was obtained from the Medical Ethics Committee under the Mongolian Ministry of Health. Results: Almost all (99.5%) children in the sample were weighed at birth with 5.0% weighing less than 2500 grams at birth and 12.6% weighing over 4000 grams at birth. The prevalence of low birth weight was slightly higher among girls than boys, however high birth weight was much more common in boys (15.9%) compared to girls (9.5%). Prevalence of low birth weight was highest in Western region (9.6%) and the poorest households (7.8%) while the prevalence of high birth weight was highest in Ulaanbaatar (13.8%) and wealthiest households1 (16.4%). High birth weight was more than double among children of overweight (17.5%) and obese (17.3%) mothers compared to children of normal weight (8.4%) or underweight (7.0%) mothers. Among singleton births, women <29 years of age had higher LBW rates than did those 30-39 years of age in both years, irrespective of birth order. LBW rate was more than double among mothers in kazak ethnic groups (13.8%). Conclusions The younger age of the mother was more likely to develop low birth weight, and it was twice as high among mothers in Kazak ethnic groups. Therefore, adolescents and women of reproductive age needed to improve the health education and to identify the causes and risk factors of low birth weight among mothers in Kazak ethnic groups.

Background: Breastfeeding is the ideal food source for all newborns globally. Proper feeding of infants and young children promotes optimal growth and development, especially in the critical window from birth to 2 years of age. Exclusive breastfeeding for 6 months and continued breastfeeding for the first 2 years of life protects children from infection, provides an ideal source of nutrients, and is economical and safe. Objective: To assess the indicators of infant feeding practices among 0- 23 months old children. Materials and Methods: The NNS V was implemented in 21 aimags (provinces) in 4 economic regions (Central, Eastern, Khangai, Western) and the capital city of Ulaanbaatar. Given the regional differences in lifestyle and nutrition status, target populations were stratified into 5 strata based on economic region and Ulaanbaatar with equal samples drawn from each stratum using a cluster-randomized sampling design [1]. The infant and young child feeding indicators assessed in the NNS V were based on the mother’s or caretaker’s report of breastfeeding and consumption of foods and fluids by the child during the day or night prior to being interviewed. Results: 83.7% of children under 2 years started breastfeeding within 1 hour of birth and though almost all children were ever breastfed (97.9%), a slightly higher percentage of girls were ever breastfed overall and within 1 hour of birth. Children 0-5 months were categorized according to whether they were exclusively breastfed or predominantly breastfed, with the former only allowing vitamins, mineral supplements, and medicine and the latter also including plain water and non-milk liquids. Among children 0-5 months of age, 58.3% were exclusively breastfed and 65.3% were predominantly breastfed, having received other liquids or foods in addition to breast milk. The prevalence of exclusive breastfeeding was lowest in the 4th wealth index quintile (46.5%) and wealthiest quintile (54.0%) households. Conclusions Exclusive breastfeeding and early initiation of breastfeeding practices are unacceptably low in Mongolia; 20% of newborns are not breastfed within 1 hour of birth and more than 40% of infants under 6 months of age are not exclusively breastfed and therefore, not receiving optimum nutritional and immunity benefits from breast milk. Strengthening IYCF counselling in all regions and wealth quintiles to support women to practice optimal breastfeeding, along with counselling and awareness of timely and adequate complementary feeding for children under 2 years of age, should be a top priority for public health and as it is a key strategy to reduce malnutrition in children.

Introduction: In Mongolia, diagnostic tests for the detection of the sexually transmitted congenital virus and human papilloma virus are currently not routinely used in clinical settings and the frequency of these STIs is enigmatic. Goal: The prevalence of this virus were prospectively evaluated among 200 Mongolian pregnant women and their newborns and correlated with pregnancy outcome. Materials and Methods: Taq Man PCRs were used to detect some virus in pre-birth vaginal swabs of the pregnant women and in oral swabs of their newborns. A standardized questionnaire concerning former and present pregnancies was developed and regression analysis was used to correlate virus detection with pregnancy outcome. Result: Cytomegalovirus was the most prevalent of the tested pathogens (46.5% positive women and 10.5% newborns), human papilloma virus (31.5% and 4.5%) and herpes simplex virus-2 (1% and 0%). Statistical analysis: The statistical analysis was conducted using the software program RStudio, version 0.99.896. Multiple regression analysis was used to assess the association between pathogen loads of mothers or newborns and the outcome variables (gestational age, neonatal length, weight, head circumferences and bacterial vaginosis). Conclusions Multiple regression analyses indicate that colonization of the mothers with cytomegalovirus is associated with transmission to newborns and that transmission is associated with reduced neonatal length and gestational age. Thus, diagnostic tests for their detection should be implemented in the clinical settings in Mongolia.

Background: The intestinal microbiota of Mongolians and its composition is of great interest of researchers, a few studies have did in this fields. Maybe Mongolian encompass a uniquely wide range of environmental conditions, ethno geographical cohorts and traditional nomadic lifestyles. Goal: We aimed to determine the amount of gut microbiota, including Lactobacillus and Bifidobacterium in the fecal samples of relative healthy Mongolian adults residing in various regions of Mongolia by conventional culture method and PCR. Material and Methods: The study was performed population based cross sectional study in healthy volunteers. In this study, 256 relative healthy Mongolian adults with no history of gastrointestinal associated diseases were enrolled between July 2018 and April 2019. Each participants was asked to complete a questionnaire containing 164 questions about demographics, physical activity, dietary habits. Fecal samples were collected for Lactobacillus and Bifidobacterium analysis using culture method and determination of genus of Bifidobacterium sрp and Lactobacillus spp by PCR. ResultsParticipants had a mean age of 38.9±12.8 years. The mean values of Lactobacillus by culture method were 5.9±1.28 and 6.24±0.94 log10 CFU/ml (4.67х106 , 4.66х106 CFU/ml), respectively. The abundance of Lactobacillus had a positive correlation with grams for fiber and amount of bifidobacterium ((r= 0.495, р<0.001, r=0.288, p<0.05), respectively). Significant difference were observed between groups of milk frequency per day for amounts of lactobacillus. In adult intestinal tracts, B.Bifidum was the most common taxon 31 (29%) followed by B. angulatum 14 (13.1%), B. adolescentis 10 (9.3%), B. catenulatum group 10 (9.3%), B. longum 9 (8.4%). B. lactis, B. breve, B. dentium and B. gallicum were subdominant species. Conclusion: The mean amount of Bifidobacterium and Lactobacillus of all participants were 6.24±0.94 and 5.9±1.28 log10 CFU/ml (4.66*106 , 4.67*106 CFU/ml) respectively. The Lactobacillus abundance of healthy adults was higher in region of Khangai, East and West of Mongolian than other regions. The composition of lactobacillus altered with ageing. Significant correlations were found between fiber, fats, potato and amount of Lactobacillus. Keywords: Bifidobacterium, Colony forming unit, Gut microbiota, Lactobacillus