1. Fall Risk Assessment Among Residents of Ulaanbaatar
Bolor-Erdene M ; Amarsaikhan D ; Amarsaikhan L ; Borte E ; Myadagmaa J
Mongolian Journal of Health Sciences 2025;88(4):71-74
Background:
Globally, approximately 684,000 deaths occur annually due to falls. In Mongolia, 47 individual aged
between 45 and 85 have died as a result of falls. Therefore, there is a pressing need to assess fall risks among the general
population in Mongolia and identify risk factors to prevent accidents and injuries.
Aim:
To assess the risk of falls among individuals aged 45 years and older who are receiving care at tertiary-level referral
hospitals in Ulaanbaatar, Mongolia.
Materials and Methods:
A cross-sectional study was conducted involving 408 participants aged 45 years and above who
were attending tertiary-level hospitals in Ulaanbaatar. Fall risk was assessed using the internationally recognized Falls
Risk Assessment Tool (FRAT) questionnaire. Data were analyzed using SPSS version 26.0.
Results:
The mean age of the participants was 59.24±6.54 years; 40% were male and 60% were female. Among the
participants, 45.3% (n=185) were categorized as low risk, 33.6% (n=137) as moderate risk, and 21.1% (n=86) as high risk
for falls. Logistic regression analysis was performed to identify significant risk factors associated with falls. Key factors
included: slippery shoe soles (OR=0.226, 95% CI: 0.119–0.428, p=0.001), performing unexpected hazardous movements
while changing positions (OR=0.262, 95% CI: 0.143–0.480, p=0.001), use of assistive walking devices (OR=0.209, 95%
CI: 0.110–0.397, p=0.001), anxiety or unstable mental status (OR=0.276, 95% CI: 0.148–0.514, p=0.001), tendency
to resist instructions or behave stubbornly (OR=0.330, 95% CI: 0.183–0.596, p=0.001), difficulty in recognizing the
surrounding environment (OR=0.354, 95% CI: 0.187–0.671, p=0.001), and a history of previous falls (OR=4.737, 95%
CI: 2.151–10.429).
Conclusion
1. Based on the FRAT assesment, 45.3% of participants had low fall risk, 33.6% moderate risk, and 21.1% high risk.
2. Risk factors such as sudden movements, the use of assistive devices, and emotional instability significantly influence fall risk assessment, and individuals with a history of previous falls are 4.7 times more likely to experience
another fall.
2.Indoor Particulate Matter Concentration in Households of Darkhan City
Nyamdorj J ; Bolor M ; Maralmaa E ; Yerkyebulan M ; Ser-Od Kh ; Myagmarchuluun S ; Shatar Sh ; Gantuya D ; Gregory C. Gray ; Junfeng Zhang ; Ulziimaa D ; Damdindorj B ; Khurelbaatar N ; Davaalkham D
Mongolian Journal of Health Sciences 2025;85(1):25-29
Background:
A 2018 study on the global burden of disease, accidents, and risk factors reported that 1.6 million peo
ple died in 2017 due to household air pollution. Poor indoor air quality has been highlighted as a contributing factor to
respiratory diseases, cardiovascular conditions, and exacerbation of asthma and allergies. A 2019 study estimated that
long-term exposure to fine particulate matter (PM2.5) with a diameter of 2.5 micrometers or less reduces average life
expectancy by 1.8 years, with more severe effects in highly polluted regions. Additionally, a study by Miller et al. (2007)
found that prolonged exposure to PM2.5 increases the risk of cardiovascular diseases, particularly among women. Direct
measurement devices are highly effective in determining indoor PM2.5 concentrations, identifying sources of pollution,
tracking pollutant dispersion, and monitoring temporal variations. Studies suggest that direct measurement is an accurate,
cost-effective method that provides detailed data suitable for local conditions.
Aim:
To investigate the indoor air quality of houses and apartments in Darkhan city during the winter season using the
Purple Air monitoring device.
Materials and Methods:
A cross-sectional study was conducted with a targeted sample of 128 households in Darkhan
city. The study examined factors such as stove type, type of coal used, annual and daily coal consumption, frequency of
heating, and chimney sealing conditions. To collect data, the Purple Air monitoring device was installed in each house
hold for a month, after which it was retrieved. During retrieval, participants completed a questionnaire. The questionnaire
consisted of 55 questions across 7 pages at the time of device installation and 25 questions across 3 pages at the time of
device retrieval. The collected data was analyzed using SPSS 25.0.
Results:
A total of 128 households in Darkhan city participated in the study. The average duration of residence in the
current home was 9.5 years, with no statistically significant variation. The distribution of housing types was as follows:
traditional Mongolian gers (40.6%), houses (39.1%), and apartments (20.3%). The 24-hour average PM2.5 concentration
was highest in gers (70.9 μg/m³), followed by houses (46.8 μg/m³) and apartments (22.8 μg/m³), with a statistically significant difference (p=0.0001). PM2.5 levels were most variable in gers, followed by houses and then apartments. House
holds using central heating (apartments) had an average 24-hour PM2.5 concentration of 22.8 μg/m³, whereas households
using stoves (gers and houses) had a significantly higher concentration of 59.4 μg/m³ (p=0.0001). However, there was
no statistically significant difference between traditional and improved stoves. Among study participants, 21.4% reported
that someone in their household smoked indoors. Additionally, 86.5% regularly burned incense, candles, or herbs, while
99.2% did not use an air purifier.
Conclusion
The indoor particulate matter concentration in houses and gers in Darkhan was 59.4μг/m3. Variations in
stove types, poor chimney sealing limited space, and frequent gaps and cracks contribute to increased spread of indoor
air pollutants.
3.Study of the factors associated with colorectal cancer
Ankhzaya B ; Enkhmend Kh ; Nomin-Erdene D ; Bolor U ; Nyamsuren M ; Sonor Z ; Chinzorig M ; Erkhembayar E ; Tsenguun G ; Yumchinsuren Ts ; Ganchimeg D ; Tegshjargal B ; Tulgaa L ; Batbold B
Mongolian Medical Sciences 2025;211(1):18-27
Introduction:
According to the World Health Organization (WHO) data from 2022, 19.9 million people were
diagnosed with cancer globally, and 9.7 million people died from the disease. In recent years,
the incidence of colorectal cancer (CRC) has been rapidly increasing, ranking 4th among all
cancers with 18.4 cases and 8.1 deaths per 100,000 population. In Mongolia, 826 new cases
of CRC have been registered over the past six years, with an incidence rate of 8.2 cases and
a mortality rate of 5.03 per 100,000 population. It is projected that by 2030, the incidence will
reach 13.28 cases and the mortality rate will rise to 8.72 per 100,000 population. We aimed
to comprehensively examine the risk factors for colorectal cancer among the population
of Mongolia, establish a scientific basis for early detection and prevention, and strengthen
preventive measures.
Materials and Methods:
A case-control study was conducted from 2022 to 2024. The study enrolled a total of 305
subjects, including 98 patients with colorectal cancer, 101 patients with colon polyps, and
106 healthy subjects. The risk. questionnaire consisted of 50 questions divided into 10
sections. All statistical analysis was performed with SPSS version 23.0 software (SPSS Inc.,
Chicago, IL, USA) and P value <0.05 was considered statistically significant. categorical
data was represented as numbers and percentages. Pearson’s chi-squared and Fisher’s
exact test were used to compare categorical variables. Multivariate logistic regression was
used to identify the risk factor associated with recurrence. The study protocol was approved
by Ethics Review Committee of Ministry of Health of Mongolia on 17 March 2023 (approval
number: 23/012).
Results:
The average age of the participants was 57.1±12.8 years. Among all study participants,
37.6% (115) were male and 62.4% (188) were female. Comparison of colorectal cancer
incidence by age and gender revealed no statistically significant differences (p=0.021;
p=0.422). Regular physical exercise was found to have a protective effect against colorectal
cancer (p=0.076; OR 0.341 95% Cl 0.118-.0986). The frequency of fruit consumption, 4 to 6
times per week (p=0.008, OR 0.08, 95% Cl 0.01-0.45), frequency of vegetable consumption
4 to 6 times per week (p<0.00; OR 0.07, 95% Cl 0.02-0.19), no dining out (0.007, OR 0.3,
95% Cl 0.18-0.68), and meat consumption (p=0.001) are decreased risk of colorectal cancer.
Conclusion
The patient's age and the presence of colon polyps are risk factors for colorectal cancer,
while regular physical activity and a diet rich in fruits and vegetables are protective factors
that help reduce the risk of developing colorectal cancer.
4.Assessment result of maintain a proper hand hygiene conditions in healthcare facilities of Mongolia
Bolor B ; Batdulam D ; Nasantogtokh S ; Myagmardorj Ch ; Myagmarjargal M ; Unurzaya E ; Oyun-Erdene O ; Enkhjargal A ; Tsegmed S
Mongolian Medical Sciences 2025;211(1):28-35
Introduction:
Safe and accessible WASH services in healthcare facilities are crucial for maintaining high
quality care, especially for maternal and newborn health. The WHO-UNICEF JMP on Water
Supply, Sanitation, and Hygiene provides reports on progress in water supply, sanitation,
and hygiene services at global, regional, and national levels, covering populations, schools,
and healthcare facilities. This assessment was conducted to address the insufficient data on
the level of hand hygiene services in healthcare facilities, following the methodology of the
JMP.
Materials and Methods:
A cross-sectional study was conducted in 319 healthcare facilities. Availability of hand hygiene
services in the study healthcare facilities was assessed using questionnaire of methodology
of the JMP. Data were analyzed using SPSS 25.0 software. Relevant parametric and non
parametric statistical analysis were conducted.
Results:
Overall, 72% and 28% of healthcare facilities had basic and limited hand hygiene service
respectively. About 18% of private healthcare facilities had limited hand hygiene service
compared to 34% of state healthcare facilities. While 20% of urban healthcare facilities had
limited hand hygiene service, 56% of rural healthcare facilities do. When examining the
level of hand hygiene services by type of medical care, specialty hospitals have 100% basic
services. Among primary care facilities, 83% of family health centers provide basic services,
while 41% of soum and village health centers meet these standards.
Conclusion
The basic hand hygiene services in urban healthcare facilities and specialty hospitals were
generally sufficient. There need to enhance basic hand hygiene service at the soum and village level. Among the assessed facilities, 81.0% met four out of the five key hand hygiene
requirements outlined in the national standard. However, additional budget allocation for
maintenance and operational costs for keeping soap and sustaining water running remains
crucial to ensure sustained compliance and quality.
5.Interdependence of hepatitis B and C virus infection with M2BPGi marker
Battulga M ; Erdembayar O ; Munkhzaya D ; Bayanmunkh B ; Oyuntsetseg D ; Enkhjin B ; Undarmaa G ; Otgontungalag D ; Bolor A
Health Laboratory 2021;13(1):21-25
Introduction:
Over 800,000 people in the world contract HCC each year and approximately 700,000 die from the disease. HCC is the 6th most common cancer in the world. HCC is the 3rd leading cause of cancer deaths in the world. 2/3 of liver cancer deaths are caused by hepatitis. In the U.S, HCV infection is the more common cause of HCC, while in Asia and Africa, HBV is more common. Mongolia ranks first in the world in mortality from liver cancer, indicating the need for early detection and treatment of cirrhosis. Sysmex Corporation has introduced for HISCL series analyser, a new cirrhosis marker M2BPGi of non-invasive, blood-testing. In 2016, the test was introduced
at Medipas Hospital in Orkhon province. It is possible to study the advantages and significance of the marker for use in clinical practice.
Materials and methods:
From a total of 385 patients who underwent M2BPGi marker testing in 2016-2017Medipas hospital laboratory, data from a total of 283 patients tested for hepatitis B and C virus and M2BRGi markers were selected. A comparison of age, sex, and test parameters of a total of HCVab and HBsAg positive 172 patients tested for Total bilirubin, GPT, GOT, GGT, AFP and M2BPGi. HCV Ab, HBsAg, AFP, M2BPGi markers were analyzed by SysmexHISCL-5000 fully automated immunological analyzer, Liver function tests were performed with a fully automatic biochemical analyzer JEOL Biomajesty BM6010/C.
Results:
Of the M2BPGi marker tested 283 patients 94 (33%) were infected with the C virus, 78 (28%) were with the B virus,11 (4%) were co-infected with B and C viruses, 100 (35%) no any viral infection. Of the 172 patients diagnosed with hepatitis B and C virus infection, 97 (56%) were male, 75 (44%) were female. In terms of age, 72% of the population is over 45 years old.
Of the 172 patients, 115 (67%) had M2BPGi marker abnormal or > 1.0 COI. Of the M2BPGi marker abnormal patients, 47 (41%) were infected with the B virus and 68 (59%) with the C virus. In terms of age, 27.7% of hepatitis B patients and 10.3% of hepatitis C patients were under 45 years of age, 72.3% of hepatitis B patients and 89.7% of hepatitis C virus patients were over 45 years of age.
Hepatitis B and C viruses are slightly more common in men than in women. The majority of patients infected with the hepatitis virus over the age of 45. The majority of patients with hepatitis virus have abnormal liver function. Increased M2BPGi markers in people under the age of 45 with hepatitis B virus infection are relatively higher for hepatitis B virus infection than for C virus infection.
Conclusions
The M2BPGi marker was abnormal in 67% of hepatitis virus infected patients. It has been observed that the probability of an increase in M2BPGi marker is slightly higher in hepatitis C virus infection than in hepatitis B virus infection.
6.Comparison of Sysmex UF-5000 with urine culture for the diagnosis of urinary tract infections
Otgontungalag D ; Battulga M ; Bolortungalag B ; Munkhzaya D ; Bayanmunkh B ; Erkhembayar O ; Oyuntsetseg D ; Enkhjin B ; Bolor A
Health Laboratory 2020;12(2):5-10
Introduction:
Urinary tract infections (UTI) are at the second place in the frequency of all causes of infection after respiratory ones. The UTI requires appropriate antibiotic treatment. 85% of UTI predictive antibiotic treatment without confirmation by bacteriological analysis. This is one of the major causes of drug resistance, especially in K.coli. Urine bacteriological tests do not show bacterial culture in all cases where the number of bacteria in the urine exceeds the reference level. Therefore, there was a need to establish criteria for urine bacteriology test based on the results of urine sediment analysis.
In 20I7, a new fully automated Sysmex UF-5000 urine sediment analyzer was installed in the laboratory department of Medipas Hospital. The features of this analyzer include counting the number of bacteria in the urine, distinguishing between gram-positive and negative, homogeneous and mixed forms, and counting the formed elements in the urine. This feature made it possible to compare the number of bacteria and leukocytes in the urine with the results of urine bacteriology tests.
Goal:
Determine the relationship between the number of white blood cells and bacteria in the urine measured by the Sysmex UF-5000 urine sediment analyzer and the results of the urinary bacteriological test.
Objectives:
Compare the number of urine bacteriaand leukocyte measured by using the Sysmex UF-5000 urine sediment analyzer with the urine bacterial culture, and calculate the correlation.
Materials and methods:
The study is analytic cross-sectional study, analyzed the results of a total of 159 people who analyzed a urinalysis and urine bacteriological test at the Medipas Hospital Laboratory in 2017-2019 years.Urine samples were collected in a 100 ml, disposable sterile container in accordance with the instructions for taking urine midstream.Urine analysis was performed within 2 hours of sampling with a fully automatic urine sediment analyzer Sysmex UF-5000 Japan. Urine bacteriological analysis was performed on a lul sterile loop of urine specimens, inoculated into 5% blood agar from Hungary's BioLab, Sabouraud agar, and Chromogen agar from Biomerieux France, and incubated for 24 hours in an incubator at 37°C. Bacterial identification and antibiotic susceptibility tests were analyzed using the "Vitek-2" analyzer from the manufacturer Biomerieux France. Bacterial and leukocyte counts data measured by the Sysmex UF-5000 analyzer and urinary bacteriological analysis data were performed using SPSS23 software.
Results:
A total of 159 urine samples were tested for bacteriological analysis, of which 81 (50.9%) were bacteria over 105 CFU/ml or urine positive culture UTIs, 78 (49.1%) were nonsignificant bactcruria and urine negative culture.The average number of bacteria measured in the urine of 81 samples with urine positive culture above 105 CFU/ ml was 46491/ul (1168-100000 BACT/ul).
The average number of bacteria measured by the urine sediment analyzer of 78 samples with urine negative culture was 2645 BACT/ ul (2-57280 BACT/ul). To calculate more accurately estimate the average number of bacteria in 81 urine specimens with positive culture, the average number of bacteria in 17 (21%) samples was 4753 BACT/ul, measured in relatively low bacteria numbers of 1168-9450BACT/ul. The average leukocyte number in the urine of 81 samples with positive culture was 472.2 WBC/ul, and the average leukocyte number in the urine of 78 samples with negative culture was 87.7 WBC/ul.There is a strong correlation between the number of bacteria measured by the urine sediment analyzer and urine bacterial positive culture, which is 0.8 or statistically significant (p<0.001).The correlation coefficient of the number leukocytes measured by the urine sediment analyzer with in the urine positive cultureof bacteriological tests was 0.6 or moderately of statistically significant (p=0.005).There is a statistically significant relationship (p=0.001) between the number of bacteria in the bacterial positive culture population and the number of leukocytes.
Discussion:
Of the 81 cases of urine bacterial positive culture, 78 (96%) were female, indicating a high prevalence of UTI among women. According to the results of the Fabio Manon's study, the number of leukocytes in the urine is 160-340 WBC/uL and the number of bacteria is 15000-30000 BACT/u,L in the case of UTI, which is approximate results compared to the our study results.Based on the results of the urine sediment analysis, indications for a urine bacteriological test should be made.
Based on the results of urinary bacteriological tests, the choice of antibiotic treatment is the best treatment for urinary tract infections and a way to prevent of antibiotic resistance to UTI.
Conclusions
The number of bacteria measured by a Sysmex UF-5000 urine sediment analyzer is directly related to the bacterial culture urine bacteriological test. If the number of bacteria in the urine is measured above 4753 BACT/ul, it can be considered as an indication for urine bacteriological analysis. Although the number of leukocytes in the urine measured by the Sysmex UF-5000 urine analyzer is moderately correlated with bacterial culture in urine bactcriologucal tests, it is a key indicator of the degree of inflammation of the urinary tract.
7.Study on the risk factors of gastric cancer
Tulgaa L ; Ganchimeg D ; Enkhmyagmar D ; Tegshjargal B ; Nasanjargal T ; Ulziisaikhan B ; Dashmaa A ; Bayar D ; Bolor-Erdene T ; Erkhembayar E ; Chinzorig M ; Serjbayar G ; Batbold B
Mongolian Medical Sciences 2020;192(2):37-44
Introduction:
In 2018, a total of 901 new cases of gastric cancer were recorded, of which 64.8% in males and
34.2% in females. The incidence rate of gastric cancer was 28.5 per 100 000 population, which 38.2
for males and 19.2 for females.
Goal:
We aimed to investigate the associations between some risk factors and gastric cancer among the
Mongolian population.
Materials and Methods:
A case-control study was conducted between November 2017 and September 2019. We selected
120 cases from National cancer center of Mongolia who newly diagnosed gastric cancer. And 120
controls were selected by matching by sex, age and the place of residence. Informed consents
were obtained from all subjects. All subjects were personally interviewed with researchers used by a
structured questionnaire consisting of 86 questions. The SPSS 21 (version 16.0, SPSS Inc., Chicago,
IL, USA) software was used for all analyses.
Results:
The mean age was 59.2±11.4 (26-85) years. Habits of having dinner after 6.00 pm (OR 1.42, 95%CI
1.11-1.83, p=0.008), having leftover meals (OR 2.22, 95%CI 1.27-3.86, p=0.008), daily consumption
of tea with salt (OR 1.97, 95%CI 1.18-3.30, p=0.01), smoking on an empty stomach (OR 2.44,
95%CI 1.11-5.37, p=0.033), weekly consumption of ham and smoked meat (OR 1.5, 95%CI 1.17-
2.13, p=0.02), and consumption of fat grease (OR 2.09, 95%CI .03-4.24, p=0.038) were significantly
increased gastric cancer risk. In contrast, habit of eating at regular times (OR 0.43, 95%CI 0.25-0.73,
p=0.002), chewing thoroughly (OR 0.39, 95%CI 0.23-0.67, p=0.001), cooking meat thoroughly until
it’s tender (OR 0.48, 95%CI 0.25-0.97, p=0.047), daily consumption of vegetables (OR 0.45, 95%CI
0.27-0.76, p=0.003), and daily consumption of fruit juice (OR 0.36, 95%CI 0.15-0.85, p=0.026) were
significantly reduced gastric cancer risk. Furthermore, having first-degree relatives diagnosed with
gastric cancer had 2-3 fold higher increased risk of gastric cancer (parents OR 2.88, 95%CI 1.07-
7.78, p=0.038, sibling (OR 3.09, 95%CI 1.09-8.81, p=0.036). Also, previous records of the digestive
disease increased risk of gastric cancer (OR 3.65, 95%CI 2.10-6.35, p<0.0001).
Conclusion
Dietary habits, family history of gastric cancer and previous records of digestive disease were
associated with risk of gastric cancer. Thus, prevention effort could be focused on the population with
a family history of gastric cancer, changing bad dietary habit and screening precancerous disease of
gastric cancer.
8.Adequacy of PhilHealth case rate coverage for pneumonia among children under 5 years old admitted in a government hospital: Policy notes
Maria Elinore M Alba-Concha ; Alvin S Concha ; Alex Ivan Junefourth Bolor
Southern Philippines Medical Center Journal of Health Care Services 2019;5(2):1-3
Thirty-seven Filipino children die of pneumonia daily, and 90% of those who die are under 5 years old.1 More than 50% of childhood pneumonia is readily treatable with antibiotics; however, only 31% of children with pneumonia receive the antibiotics they need.2 From 2016 to 2018, pneumonia and acute lower respiratory tract infection (ALRTI) comprised the 3rd leading cause of morbidity in the Philippines across all age groups. In 2018, there were 213,611 reported cases of pneumonia and ALRTI among Filipino children <5 years old.3
In 2011, the Philippine Health Insurance Corporation (PhilHealth) created case rate packages for selected medical procedures and medical conditions, including pneumonia. A case rate is a fixed amount that PhilHealth pays to a health care provider for the diagnostic and therapeutic care of a patient with a particular disease or condition. The case rates for moderate-risk and high-risk pneumonia are PHP 15,000 and PHP 32,000, respectively.4 PhilHealth also introduced a no-balance-billing (NBB) policy, applicable to all PhilHealth Sponsored Program members and/or their dependents when they seek health care in a government hospital for diseases or conditions included in the case rate packages. The policy provides that government hospitals shall not charge other fees or expenses beyond the case rate to patients covered by the policy.4 Given the high incidence of pediatric community-acquired pneumonia (PCAP), policies that support current efforts in attaining adequate financial protection of patients--or their families--would certainly improve health outcomes related to the disease. The aim of this article is to recommend health policies based on the results of a study on health insurance coverage of patients with PCAP.
9.The most frequently used medical raws for the treatment of
Delgermaa E ; Ambaga M ; Khurelchuluun B ; Bolor B ; Bazarragchaa
Mongolian Pharmacy and Pharmacology 2019;15(2):12-15
Background:
Some findings of an artifacts have revealed that nature based the raw have been used for the treatment of mankind's diseases over 60 000 years ago. WHO estimates that about 80 percentage of the world's population are consume the traditional medical care, and uses more than 21,000 plant species for therapeutic purposes. In order to help guide its member countries the World Health Organization (WHO) has developed The WHO Traditional Medicine Strategy 2014-2023. Some of the strategic actions in this document include:
• To develop and share appropriate research methodologies and criteria for evaluating the safety, efficacy, and quality of TM (Traditional Medicine) products;
• To study and explain the disease prevention, health maintenance, the diagnosis and the treatment of the TM disease according to the evidence based scientific studies.
Objectives:
to determine the most frequently used medicinal plants for the treatment of "Rlung" in the TM.
Methods:
The comparison method, the synthesis and analysis method, the induction and deduction method, the listing and sorting method, the inspecting and arrange method, and the methods of documents' drafting were used in this study.
Results:
It is shown that over 80 raw materials of plant, mineral and animal origins has to list within 32 drug recipes which used "Rlung" disease of TM. The first five raw materials from these 80 ingredients have been repeatedly lists zadi - 30, agar (black, white, red agar) -19, arur-19, lish -18, and nin shosh -18 times.
Conclusion
The most frequently used the raw materialin the treatment of "Rlung" diseases is the seeds of Myristica fragrans Houtt. which contains a lot of the saturated acids with membrane-enhancing effects and strong antioxidant substances.
10.Issue in late diagnosis of gastric cancer
Tulgaa L ; Ganchimeg D ; Chinzorig M ; Erkhembayar E ; Tegshjargal B ; Nasanjargal T ; Dashmaa A ; Bayar D ; Tsegmed S ; Bolor-Erdene T ; Otgonbayar I ; Batbold B
Mongolian Medical Sciences 2019;187(1):42-47
Introduction:
Gastric cancer is still one of the most leading causes of mortality in the world. The highest mortality rate of gastric cancer is estimated in Mongolia. South Korea and Japan, where leading the incidence of gastric cancer, mortality rates are observed in 51th and 31nd rank respectively. In Mongolia, gastric cancer is the second leading site, after liver cancer.
Goal:
We aimed to determine the cause of late diagnosis of gastric cancer and to evaluate supply of upper endoscopy devices and human resource for gastric cancer in the general hospital of provinces and districts.
Materials and Methods:
In this study, 84 patients suffering from gastric cancer (42 patients in III, IV TNM stage; 42 patients in I, II TNM stage)were investigated in National Cancer Center, Mongolia. A survey questionnaire which included age, gender, education, income, risk factors and clinical questions was detected from all patients. And we conducted study of supply of upper endoscopy devices and human resource for gastric cancer in general hospitals of from 21 provinces and general hospitals of 6 districts by questionnaire.
Results:
Seventy three(86.9%) patients were over 50 years old and the highest rates of gastric cancer were in group of 61-70 years (40.5%). From the results, the reason to visiting hospital was significantly different between two groups. 55.1% of patients suffering from early-stage gastric cancer were voluntarily diagnosed by upper endoscopy. In contrary, 55.8% of patients suffering from late-stage gastric cancer have visited the hospital due to worsening symptoms or dysphagia and vomiting. Factors such as age, gender, education, employment status and income had no significant effect on late diagnosis of gastric cancer. In totally 24(89%)general hospitals out of 27 had upper endoscopy devices and 22 (81.5%) hospitals had endoscopist. Although 75% of total general hospitals conduct
annual cancer screening, 64% of them do not perform the endoscopy in annual screening.
Conclusion
In our country, late diagnosis of gastric cancer is related to the attitudes of patients for preventing and screening disease. Therefore, it is important to improve the health education of the population and to develop healthy, right attitudes and practices. And the study revealed that general hospitals have insufficient for upper endoscopy devices and human resource.

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