1.Nonadherence to medical therapy and risk factors of non-compliance among mongolian people with essential arterial hypertensiony
Tsolmon U ; Naranchimeg S ; Angarmurun D ; Baigal L ; Zolzaya B
Mongolian Medical Sciences 2012;159(1):15-21
Introduction: The World Health Organization describes poor adherence as the most important cause of uncontrolled blood pressure and estimates that 50–70% of people do not take their antihypertensive medication as prescribed.Goal was to measure non-adherence to antihypertensive therapy in a representative sample of the hypertensive Mongolian population and to define the factors associated with non-adherence in the studied population.Materials and Methods:This descriptive study was a questionnaire-based cross sectional analysis. A simple random sample of 735 hypertensive patients, aged 35-64 years was selected. The questionnaire included sociodemographic characteristics and awareness about hypertension and anti-hypertensive treatment, and factors that encouraged or discouraged the patient’s drug taking behavior. Adherence was assessed using the Morisky Medication Adherence Scale (MMAS), with a 4-item questionnaire. Blood pressure was measured twice by the physicians using aneroid sphygmomanometers and stethoscopes. Results and Discussion: The study sample consisted of 265 men (36.1%) and 470 women (63.9%). The mean age of participants was 53.8 ± 8.7 years. The non adherence to medical treatment found in the our study was 68.3% of hypertensive patients. We found younger age (35-44), low family income, not having a regular doctor towards hypertension control, behaviour not taking drug regularly, monotherapy and lack of patient’s knowledge to be the significantly factors influencing on non-adherence to anti-hypertensive medication among Mongolian hypertensive population. The non adherence to antihypertensive treatment found in the current study was higher than that of 25.9%-55.8% found in the study done in Malaysia, Pakistan and Egypt and lower than what a study in the Bangladesh , India and Brazil (74.2%-90.0%)population.Conclusion: The level of adherence to treatment among the participants in this study seriously needs to be improved through well designed health promotion and education strategies in order to prevent poor treatment outcomes.
2.The current situation of the early detection and control of hypertension and its strategy
Nandintsetseg B ; Baigalmaa L ; Tsolmon U ; Serjee D ; Zolzaya B ; Angarmurun N
Mongolian Medical Sciences 2010;153(3):6-11
Background According to the report of World Congress of Cardiology in 2007, 1.5 billion people had hypertension and 45% of hypertensive people were unaware of their condition. In our country, some study had provided estimation of risk factors and prevalence of hypertension, but main characteristics presenting the early detection and control of hypertension have not been studied well and information does not exist.The quality of the control, registration and early detection of hypertension will be improved by studying this topic and complications and mortality due to the hypertension could be decreased.GoalThe aim of our study is to evaluate the current situation of the early detection, registration and control of hypertension, and to describe future strategyObjectives:1. To describe the hypertension awareness and risk factors associated with early detection of hypertension2. To evaluate the current situation of registration system of hypertension and to find out the strategies for renewing registration system3. To investigate the rates of the treatment and control of hypertension, and to survey factors associated with the control of hypertensionMaterials and MethodIt was population based, cross sectional, prospective study. Participants of the study were selected by randomized method.In the study, 1103 individuals, 133 physicians and 2 family hospitals located in Bayanzurkh, Songinokhairkhan districts, were surveyed. The study based on questionnaire and BP measurement which aimed to reveal:• Hypertension awareness (%)• Treatment (%)• Control (%)Software program name: Arterial hypertension registration and control Objectives of the program: to evaluate registration of arterial hypertension, to detect earlier, to determine control level of hypertension Users: family hospitals, family doctorsType of morbidity registration: population basedStatistical analysis was performed with SPSS-17 software program. Single- and multi-factorial analysis was explored by using simple and logistic regression and significance.ResultsIn the study, in total, 1103 people aged of ≥18 years living in Bayanzurkh and Songinokharkhan districts of Ulaanbaatar, have been involved. 37% of all participants were male and 63% were female and mean age of all participants was 40.6±16.1. According to our study, 305 individuals of 431 hypertensive participants (70.8%) were aware of their hypertension. This result was different in gender: 58.0% in male, 79.0% in female. Our research team created software program that can integrate all hypertension data to one database. We are planning to determine unawereness; aware and treated; treated and controlled; and uncontrolled levels by using this software and to introduce the program created by us to all primary level physicians in order to use routinely.Conclusions:1. Among hypertensive individuals, awareness of hypertension was 70.8%. Factors such as young age (<35), single people and not measuring BP for the last one year influence negatively on early detection of hypertension (p<0.05).2. Current method of hypertension registration is not proper at the time. Therefore, we concluded that renewing of the arterial hypertension registration database and conversion it into electronic type is convenient to control arterial hypertension and to provide integration.3. Treatment level of arterial hypertension was 39.9%, controlled arterial hypertension among all hypertensive population - 10.2% and among treated population – 25.2%.
3. EVALUATION OF THE SECONDARY SCHOOL EXTERNAL ENVIRONMENT SOLID WASTE MANAGEMENT IN ULAANBAATAR MONGOLIA
Zolzaya D ; Ser-Od Kh ; Batzorig B ; Nandin-Erdene O ; Oyunbileg N ; Davaalkham D
Innovation 2015;9(3):160-162
A school environment may cause positive effect upon health and healthy behavior, but also representmain factor for transfer of non-infectious diseases. Therefore, the issue of maintaining an appropriate environment in operations of training and educational institution would be considered as vital in every country of the world. In our country the solid waste hygienic conditions around children organizations represent one of actual problems. Through the research work was aimed to evaluate the state of solid waste at external environment of general educational institutions by the momentum model of analytical research and involving 103 state proprietary Educational Institutions of 9 districts. At developing estimation list of solid waste at external environment of schools were used current effective standards, resolutions and regulations. 88.3 percent of schools involved into research work had special solid waste-points and 11.7 percent had no special solid waste-points. 38.8 percent of solid waste-points were fenced from all sidesand 44.7 percent fenced from some sides and 16.5 percent had no fence in whole. The research of material from which was made a solid waste-keeping facility showed that 44.2 percent were made from metal, 2.3 percent from wood and 52.3 percent from brick. When we studied whether the solid waste-keeping facility is placed in distance of 25 meters from school according to standard,was determined that 71.8 percent were built according to the standard, 28.2 percent were allocated within 25 meters showing inconformity with the standard. During the research it has been detected that among schools 27.2 percent had too much solid waste-heap, 25.5 percent had placed no special recycle-bins on the school site and 13.6 percent conducted wrong activity by incinerating solid waste on the territory of school.2/3 or total 63 schools among Metropolitan state proprietary educational institutions has non- standard solid waste-keeping facility, 1/3 or 29 schools has located their solid waste-points in non- standard distance, there exists much solid waste-heap because of insufficient recycle-bins, absence of solid waste-points results in collection of solid waste in a special room inside of school and later its transportation with scavenger. Also, 13.6 percent or 14 schools are incinerating their solid waste within school site. This breeches effective hygienic norms and normative.
4.ЭХЭМҮТ-Н ХЗП-Н СОНСГОЛ ЗАСЛЫН КАБИНЕТААР ҮЙЛЧЛҮҮЛСЭН ГАДНА ЧИХНИЙ ГАЖ ХӨГЖИЛТЭЙ ХҮҮХДҮҮДИЙН ХЯНАЛТЫН СУДАЛГААНЫ ЗАРИМ ҮР ДҮН
Ariuntuya D ; Zolzaya Ts ; Enkhtunsag B ; Temuulen B
Innovation 2018;12(3):18-21
BACKGROUND: Microtia is often associated with hearing loss and patients typically
require treatment for hearing impairment and surgical ear reconstruction. The
occurrence of microtia is of public health importance in part due to the psychosocial
sequelae, including the stigma associated with malformations of the ear and the burden
of undergoing multiple surgeries
In addition, greater than 90% of individuals with microtia experience conductive hearing
loss on the affected side. Although children with microtia-anotia are at a greater risk of
delayed language development and attention deficit disorders.
METHODS: Our study has a 173 childrens from the UB city and countryside. 23 children
has a bilateral microtia and anotia. 6 patient wearing BAHA soft band from 6 months
age. 150 patients have an unilateral microtia. Microtia was found more commonly in
males, unilateral and right sided. Even children with bilateral microtia may have wearing
BAHA soft band before 6 months age.
RESULTS: External ear malformations are more commonly found in males. Sex ratio 2:1.
From other studies right ear malformations are more common in male children. In our
study children who have bilateral ear abnormalities wearing BAHA softband and
language therapy from 6 months age to able to have normal language development.
Children who had surgical treatment and using hearing aid can have normal social life
and increased quality of life.
CONCLUSION: Early screening in children who have external ear malformation,
monitoring language development, wearing BAHA softband from 2 months age who
have bilateral ear malformation and one ear affected other one is normal children
wear BAHA softband increases children speech and language development.
5.Satisfaction of health care and services for parents and guardians with 0–5 years-old children
Bolor B ; Enkhtuya P ; Tsegmed S ; Oyunchimeg D ; Zolzaya D ; Bolormaa L ; Chinzorig B ; Amartuvshin T ; Suvd B
Mongolian Medical Sciences 2021;196(2):37-45
Introduction:
Within the framework of health sector reform, the development of the organization, the responsibility
of doctors and medical professionals, and the improvement of ethics, quality and safety of care and
services are top priorities. Customer satisfaction is important for the implementation of this operation
based on results and quality. The WHO Recommendation states that health professionals have a key
role to play in providing information and advice to citizens and their families on how to prevent, mitigate
and address air pollution, and how to inform the general public and decision-makers. ADB, the Ministry
of Health, and UNICEF report that information and promotional materials on air pollution prevention
are scarce and do not provide advice to clients. Therefore, it is the reason for conducting a survey to
determine the level of satisfaction of clients receiving child health care.
Materials and methods:
The survey data were collected using quantitative and qualitative research methods. In this study, totally
1160 guardians of children aged 0-5 participated from Songinokhairkhan and Bayanzurkh district and
Bayankhongor aimag center. The overall satisfaction of health services is calculated using the three
dimensions namely: satisfaction with health service, operation and environment of Health Organization.
Satisfaction scores were assessed using an even-point scale. These are “Very Dissatisfied-1 point”,
“Dissatisfied-2 point”, “Satisfied-3 point”, “Very satisfied-4 point”. The results were calculated after
entering the survey data into SPSS-23, creating a database, and performing error control. Research
methodology discussed at the meeting of the Academic Council of the National Center for Public Health
on December 25, 2019, and the methodology was approved by the Medical Ethics Committee of the
MOH (Stagnant №2).
Results:
84.7 percent of the respondents were parents of children aged 0-5 years. Their average age is 34,
most of them have higher education, and 43.0 percent of them have a household income of 500,000-1
million MNT. Guardians of children aged 0-5 years in Bayanzurkh District were “dissatisfied” with the
Family Health Center’s dressing room, wardrobe, toilet and parking lot. Guardians of children aged
0-5 years in Songinokhairkhan district were “dissatisfied” in the parking lot and toilet of the health
organization. Guardians of children aged 0-5 years in Bayankhongor aimag were satisfied with the
services, operation and environment of the health organization. Studies have shown that 76.5 percent
of the guardians did not receive air pollution risk training. As for difficulties in preventing air pollution,
31.4 percent of the surveyed population answered that they cannot change their living and working
environment to prevent air pollution.
Conclusion
It shows the health care organizations need to improve the hospital environment as well as to provide
training how to protect children from air pollution risk for guardians.
6.Evaluation of air pollution prevention consultation, Ulaanbaatar
Zolzaya D ; Bolor B ; Oyunchimeg D ; Enkhtuya P ; Tsegmed S ; Bolormaa I ; Chinzorig B ; Amartuvshin T ; Suvd B
Mongolian Medical Sciences 2022;199(1):74-82
Introduction:
Mongolia’s capital hosts about half the country’s total population, and its air pollution ranks among the highest in the world during winter. Air pollution is linked to reduced fetal growth, preterm birth, low birth weight, impaired cognitive intra-uterine development, impaired cognitive development, and even spontaneous abortion. Antenatal care includes fetal development monitoring, prevention of anemia, immunization against infectious diseases, prevention of sexually transmitted diseases, and any health risk factors such as environmental pollution.
Health care measures for pregnant women and children under one year of age have the potential to be highly effective because they are directly aimed at reducing pneumonia in children. As such, we need to conduct this survey to determine whether pregnant women were satisfied with the information and advice on air pollution prevention provided by health facilities and to take evidence-based measures.
Materials and Methods :
The survey data were collected using quantitative and qualitative research methods. In this study, a total of 958 pregnant women participated from Songinokhairkhan district, Bayanzurkh district, and Bayankhongor province center. The overall satisfaction of health services is calculated using the three dimensions namely: satisfaction with health service, operation, and environment of the Health Organization. Satisfaction scores were assessed using an even-point scale. These are “Very Dissatisfied-1 point”, “Dissatisfied-2 point”, “Satisfied-3 point”, “Very satisfied-4 point”. The results were calculated after entering the survey data into SPSS-23, creating a database, and performing error control. The research methodology was discussed at the meeting of the Academic Council of the National Center for Public Health on December 25, 2019, and the methodology was approved by the Medical Ethics Committee of the MOH (Stagnant №2).
Results :
The survey covered 958 pregnant women aged 16-45 in Bayanzurkh district Songinokhairkhan district, and Bayankhongor province. During antenatal care visits, the majority of pregnant women (BZD- 56.9%, SKHD- 68.3%, BKH province - 86.7%) were advised by their health specialists to go outside for fresh air, while women in Ulaanbaatar (BZD- 18.9%, SKHD- 24.7%) received the information and advice at the lowest percentage. Pregnant women in Ulaanbaatar were less involved in air pollution training than in Bayankhongor. Participants in the air pollution prevention training rated it as “satisfied” regardless of location. 37.2% of pregnant women obtained information on protecting their health from air pollution from the board of Family Health Center and 34% from their district health centers. 86.1% of the participants were able to obtain information on air pollution on their own, while 86% of them got information from their family and friends.
Conclusion
The percentage of pregnant women getting medical advice, training, and information on air pollution prevention from hospitals during their antenatal care visits was the highest in rural areas. Moreover, their level of satisfaction with counseling had been rated as “satisfied”. Pregnant women often seek information on air pollution prevention from non-professional sources, such as their family and friends.
7.Assessing quality of life among patients with pulmonary embolism
Javzan-Orlom D ; Munkh-Erdene D ; Zolzaya B ; Solongo B ; Chuluunbileg B ; Altankhuyag N ; Badamsed Ts ; Tumur-Ochir Ts
Mongolian Journal of Health Sciences 2025;86(2):154-159
Background:
The assessment of patients’ quality of life has emerged as a critical metric in evaluating healthcare services.
Internationally, numerous studies have been conducted to assess the QoL of individuals diagnosed with pulmonary
embolism through the development of standardized questionnaires and their association with various clinical parameters.
Aim:
To adapt a standardized questionnaire for assessing the quality of life following a pulmonary embolism and to evaluate
the quality of life of affected patients.
Materials and Methods:
A total of 33 patients diagnosed with pulmonary embolism and hospitalized in the Department
of Pulmonology at the Third State Central Hospital in Mongolia between August 2022 and December 2023 were included
in the study. An observational cross-sectional study design was used. Inclusion criteria encompassed all patients diagnosed
with PE during the study period, while exclusion criteria included individuals with severe comorbidities, those aged
over 85 years, and those who declined participation. QoL was assessed using the Pulmonary Embolism Quality of Life
(PEmb-QoL) questionnaire, which consists of 39 questions categorized into six domains. Higher scores indicate poorer
QoL. Data analysis was performed using SPSS version 16.
Results:
The average age of the participants was 61±15 years, and 18 (54.5%) were female. The median duration of anticoagulant
therapy was 170 days (range: 27–2555 days), and the average monthly expenditure on medication was 80,000
MNT (range: 63,000–400,000 MNT). The overall mean QoL score was 69.7±23.2. The median scores for the six domains
were as follows: frequency of complaints 1.6 (IQR 1.5-1.9; max 5 score), activities of daily living limitations 1.5 (1.3–1.8;
max 3 score), work-related problems 1.7 (1.5–2.0; max 2 score), social limitations 2.0 (2.0–3.0; max 5 score), intensity
of complaints 3.0 (3.0–4.0; max 6 score), emotional complaints 2.0 (1.5–2.4; max 6 score). The internal consistency reliability
of the questionnaire was assessed, with the symptom frequency category scoring well (α=0.74), while the other
categories had excellent reliability (α>0.85). A weak positive correlation was observed between overall QoL scores and
age, while a weak negative correlation was identified with body mass index (r=0.14 & r= -0.13, P>0.05).
Conclusion
The study findings indicate a low QoL among PE patients, emphasizing the necessity for enhancements in
post-diagnosis medical care and long-term management strategies to improve patient outcomes.
8.Health professional’s knowledge, attitude and practice (KAP) on air pollution
Otgonbayar D ; Tsegmid S ; Suvd B ; Oyun-Erdene O ; Buuveidulam A ; Zolzaya D ; Oyunchimeg D ; Chinzorig B ; Amartuvshin Ts ; Enkhtuya P ; Narantuya D
Mongolian Medical Sciences 2020;193(3):54-58
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.
9.Study on Students’ Eating Behavior and Some Influencing Factors
Zolzaya B ; Altanchimeg D ; Ser-Od KH ; Khandmaa S ; Darambazar G
Mongolian Journal of Health Sciences 2025;85(1):96-101
Backround:
The university period is a unique phase in students’ lives, often marked by independent living, changes in
lifestyle, diet, sleep patterns, increased psychological stress, and the development of unhealthy behaviors. Among students, particularly those studying in the medical field, research on dietary habits and influencing factors is scarce in our
country, which serves as the rationale for this study.
Aim:
The aim of this study is to investigate the dietary habits of medical students and the factors influencing them, including sleep, impulsivity, depression, anxiety, and stress.
Materials and Methods:
A cross-sectional study was conducted among 358 students from years 1 to 6 across 7 schools of
the Mongolian National University of Medical Sciences (MNUMS). Data were collected using internationally standardized and validated questionnaires, including the Three-Factor Eating Questionnaire Revised-18 (TFEQ-R18), the Short
UPPS-P Impulsive Behavior Scale-20 (SUPPS-P-20), the Depression, Anxiety, and Stress Scale-21 (DASS-21), and the
Pittsburgh Sleep Quality Index (PSQI). Statistical analysis was performed using SPSS 25.0.
Results:
In terms of eating behavior, uncontrolled eating (UE) and cognitive restraint (CR) were similar between male
and female students, while emotional eating (EE) was more prevalent among male students. Students’ eating behaviors
were associated with body mass index (BMI). As BMI increased, levels of depression, anxiety, and stress also tended to
rise. Sensation-seeking and positive urgency were higher among female students. Overall, 83.5% of students had poor
sleep quality, which contributed to increased depression, anxiety, stress, and impulsivity. Psychological burden and impulsivity were independent of the field of study but decreased as students progressed through their academic years, while
sleep quality improved.
Conclusion
The dietary habits of medical students were similar across genders but varied by academic year and field
of study. Poor sleep quality, observed in 83.5% of students, was associated with increased depression, anxiety, stress,
and impulsivity. Psychological burden and impulsivity were unrelated to the field of study but decreased with advancing
academic years, alongside improved sleep quality. As BMI increased, cognitive restraint in eating behaviors decreased.
10.The intolerance of uncertainty and mental health
Enkhzaya B ; Zolzaya D ; Mungunchimeg D ; Uynga Ts ; Enkhnaran T ; Tserendolgor U ; Xihua Zeng ; Gantsetseg T
Mongolian Medical Sciences 2022;200(2):16-23
Background:
Numerous studies among the western population have been demonstrated that the intolerance of uncertainty can cause mental disorders such as OCD, anxiety disorder major depressive disorder. The lack of research in this field among the eastern population, especially the Mongolians, is the basis of our study.
Material and Methods
The study was designed as a cross-sectional study with a self-report questionnaire and conducted between December 5th and February 5th of 2022. The Intolerance of Uncertainty scale (IUS-12) is for measuring intolerance of uncertainty, Patient health questionnaire (PHQ-9), and Generalized anxiety disorder (GAD-7) were used to measuring mental health among study participants. The present study was undertaken following ethical approval from the MNUMS scientific research ethics committee (approval number: 2021/3-06). Statistical analysis was performed using SPSS version 24.
Purpose:
The current study was aimed to explore the impact of intolerance of uncertainty on students’ mental health.
Results:
Total of 3137 students (2440 Chinese, 697 Mongolian), 65.7% of them were female students participated in the current study. The mean score of IUS-12 was 33.53±7.72 among Chinese students, while 38.65±8.48 among Mongolians. This reveals the statistically significant (p=0.003) difference intolerance level between Chinese and Mongolian students. Moreover, Chinese students were less depressed and less anxious than Mongolian students. The anxiety and depression level was directly impacted by the influence of intolerance of uncertainty.
Conclusion
Chinese students are more tolerant toward uncertainties than Mongolian students. The intolerance of uncertainty causes depression and anxiety, regardless of nationality.