1.Antibiotic Resistance of Helicobacter pylori in Mongolia
Oyunbaatar A ; ; Gerelmaa E ; ; Narmandakh B ; Birgit Henrich ; Battogtokh Ch ; Avarzed A
Mongolian Journal of Health Sciences 2026;93(3):78-84
Background:
Helicobacter pylori is a highly prevalent pathogen infecting more than half of the global population, with considerable geographic variation in its genetic characteristics and antibiotic resistance patterns. The EPIYA motifs of the CagA protein play a critical role in bacterial virulence; however, data on the association between CagA genotypes and antibiotic resistance remain limited in Mongolia.
Aim:
To determine the antibiotic resistance, CagA EPIYA patterns, and clarithromycin resistance-associated mutations of H. pylori strains in Mongolia, and to evaluate the agreement between phenotypic and molecular diagnostic methods.
Materials and Methods:
Gastric biopsy specimens were collected from 210 patients undergoing endoscopy and cultured for H. pylori. Antibiotic susceptibility to metronidazole, clarithromycin, amoxicillin, levofloxacin, and tetracycline was determined using the E-Test method according to EUCAST guidelines. CagA EPIYA patterns were analyzed, and clarithromycin resistance-associated mutations (A2142C, A2142G, A2143G) were detected using real-time PCR.
Result:
H. pylori was successfully cultured in 86 of 210 samples (41%), and 61 isolates were included in the final analysis. CagA-positive strains accounted for 86.9%, with a predominance of Western-type CagA (52/53), while only one East Asian-type strain was identified. Among Western-type strains, the ABC (58.5%) and ABCC (37.7%) patterns were most common. The highest resistance rate was observed for metronidazole (70.5%), followed by levofloxacin (50.9%). Clarithromycin and amoxicillin resistance were both 19.7%, whereas no resistance to tetracycline was detected. Multidrug resistance (≥2 antibiotics) was observed in 45.9% of isolates, and 14.8% showed resistance to ≥3 antibiotics. Clarithromycin resistance-associated mutations were detected in 21.3% of isolates, predominantly A2143G. The agreement between E-test and real-time PCR methods was excellent (κ=0.95, p<0.001).
Conclusion
H. pylori strains in Mongolia are characterized by a predominance of Western-type CagA, with ABC and ABCC as the most common subtypes. Notably, the AAABC and AAAAB subtypes were identified for the first time. High levels of antibiotic resistance, particularly to metronidazole and levofloxacin, as well as a substantial prevalence of multidrug resistance, highlight the need for region-specific treatment strategies. In Mongolia, H. pylori demonstrated the highest resistance to metronidazole, accompanied by a high proportion of multidrug-resistant isolates.
2.Analysis of reproductive health education levels and curriculum content gaps
Ariunzaya G ; Enkhbayar U ; ; Nandin-Erdene S ; Batsetseg B ; Narmandakh D ; Udval N
Mongolian Journal of Health Sciences 2026;95(5):123-130
Background:
Globally, adolescent sexual and reproductive health (SRH) remains a public health priority within the Sustainable Development Goals. In Mongolia, individuals aged 15-24 account for over 40% of all sexually transmitted infections (STIs), representing a significant national challenge. Current health education for adolescents focuses predominantly on biological knowledge while neglecting life skills, consent, and communication. This focus has led to a deepening “knowledge-practice gap,” increasing vulnerability to risky behaviors. Therefore, it is essential to identify the actual SRH needs of youth and evaluate the national curriculum against international Comprehensive Sexuality Education (CSE) standards.
Aim:
To compare and evaluate the SRH knowledge, attitudes, and practices (KAP) of university students and to identify content gaps by comparing the national curriculum with international CSE standards.
Materials and Methods:
An analytical case-control study was conducted among 585 students (freshmen, n=289; senior students, n=296) using random sampling. Data were collected via a structured questionnaire based on UNESCO CSE standards and the national curriculum. Statistical analysis was performed using SPSS 26.0, employing X2 and t-tests for significance (p<0.05). Content analysis was executed using a triangulation matrix.
Results:
Statistically significant differences were observed between the study groups in terms of age (p<0.001), marital status (p<0.001), and living environment (p<0.001), while groups were homogeneous regarding gender (p=0.183) and socio-economic status. Senior students demonstrated significantly higher levels of SRH knowledge, attitudes, and practices across all variables compared to freshmen (p<0.001). However, a profound knowledge-practice gap persists; for instance, while 70% of freshmen were aware of STI transmission routes, regular condom use was reported at only 45%. Content analysis revealed that while the national curriculum covers biological aspects well, key CSE concepts such as “Consent,” “Psychology of Relationships,” and “Digital Safety” are notably absent. Furthermore, a curriculum based on negative attitudes and “prohibitions” contributes to fear among youth regarding seeking medical assistance.
Conclusion
The significant knowledge-practice gap (p<0.001) among students highlights the urgent need to revise the national curriculum in alignment with international CSE standards. To mitigate risky behaviors, it is recommended to transition from information-based teaching to a competency-based “Integrated Learning Model” supported by school-hospital-family partnerships.
3. Comparison of CSF analysis by manual counts and automated hematology analyzer Sysmex XN-2000
Bolor A ; Oyunkhand L ; Erdenechimeg D ; Narmandakh G ; Gerel A ; Narantuguldur D ; Oyunchimeg R ; Naran G
Health Laboratory 2016;5(1):12-15
Introduction:When a central nervous system disorder (meningitis, encephalitis, hemorrhage, leukemia infltration and other neoplasma) is present, cerebrospinal fluid (CSF) shows various changes that reflected the condition. Therefore it is essential to test CSF. Different types of CSF tests include cell count; cell differentiation; chemistry; immunology; microbiology and molecular biology. CSF cell count and cell differentiation in particular, are crucial in differentiating diagnosing various CNS disorder needing immediate care and in evaluating the treatment. The patient’s prognosis largely depends on how accurate diagnosis was done and how early treatment was provided. There for CSF test require high precision and accuracy. In Mongolia until now 2st and 3st level hospital using manual method for CSF cell count and cell differentiation test. In this test has 2 actual problems, which is depends on the analytical techniques, skills and sample stability specific problem. But in Japan in 2011 newly designed Sysmex XN Series hematology analyser with body fluid mode (CSF,pleural effusion, peritoneal and synovial fluid). On The First Central Hospital of Mongolia In 2013 frst timeinstalled Sysmex XN-2000 hematology analyser andpossible use of body fluid automatic testing methods.Materials and methods:We evaluated the basic assay performance of the body fluid mode on the automated hematology analyzer XN-2000, which is used for analysis of CSF fluid. We compared between the manual method and XN-2000 analysis for nucleated (WBC), mononuclear (MN) and polymorphonuclear (PMN) cells was also randomly studied using 10 CSF samples of inpatient section our hospital.Results:In CSF samples the coeffcient correlation(r) for WBC/µl, MN%, PMN% were respectively 0.83, 0.95 ба 0.95.Discussion:The correlation for MN%, PMN% were between automate and manual method was good, that is similar to the other researchers. Whereas the correlation for WBC/µl slightly low, this was probably correlation relatively weak or show discrepancies. In introduction inscriptive in analysis accuracy can to affect analytical techniques skills, sample stability and specifc many problems. Therefore scientifc studied and proven ability specifcity, sensitivity, reproducibility, quality, personnel low cost and spend less time, automatically Sysmex XN series hematology analyzer is desirable to domesticate an appropriate level of medical laboratories.
4. The evaluation of immunosuppressive regimens in kidney transplant Mongolian recipients
Sarantsetseg J ; Narmandakh G ; Bolortuya KH ; Oyungerel TS ; Batbaatar G ; Munkhbat B ; Nyamsuren D
Health Laboratory 2015;4(1):8-14
Background:However kidney transplantation has being performed in Mongolia since 2006, because of pre-transplant ensitization, ABO incompatibility, hepatitis B and C virus activation many patients are taken kidney transplantation in abroad. The transplantation centers use own immunosuppressive regimens.Objective:Our aim was to assess the immunosuppressive regimens efficacy and toxicity in kidney transplant Mongolian recipients.Material and Methods:We analyzed data from 96 adult kidney transplant recipients who had taken kidney transplantation in different transplant centers from August 2006 through January 2014. There were 3 kinds of regimens Group I Simulect induction with standard triple /FK506/CyA+MMF/AZA+steroid/, Group II Campath-1H induction with CNI monotherapy and Group III Campath-1H induction with standard triple /FK506/CyA+MMF/AZA+steroid/. We retrospectively collected the post-transplant first two year serum creatinine. The study was performed in 2014. The questionnaire was taken and blood samples collected for determination of tacrolimus through level and for other laboratory tests. The primary end point was the first two years serum creatinine, the secondary end points included rejection episodes, blood through level of tacrolimus and some laboratory findings.Results:The post-transplant first two years serum creatinine levels were significantly different in 3 groups. Group III showed similar results compared to Group I. There was not enough data of biopsy proven acute rejection episodes however group II said more rejections occurred. However participants said that rejection occurred in 15 (15.6%) biopsy was done only 3 (3.1%) cases. Blood through level of tacrolimus was significantly different in three groups. Some laboratory findings showed different between three groups.Conclusion:A regimen of Campath-1H induction with CNI monotherapy (Group II) may be advantageous for short-term renal function and cost effective but there were more rejection complications and increased creatinine. The regimen of Campath-1H induction with standard triple (Group III) may be advantageous for long-term renal function, allograft survival, but there should consider about infection complications and polycythemia. Simulect induction with standard triple could be best choice but transplantations were performed in experienced centers. The study enrolled few cases and cases which were performed at the beginning of transplant program so many things could influence on the result. The study was compared beginner transplant center with experienced centers. Longitudinal cohort study needed in the future.
5.Affecting the night shift work on nurse’s health
Narmandakh S ; Naranchimeg S ; Solongo D ; Solongo TS
Mongolian Medical Sciences 2012;159(1):37-42
Introduction: The researchers have identified that shift work of nurses can have a direct impact on health, well-being, performance, and organizational outcomes. In countries with self sustainable and highly developed nursing science it was established that shift duration of hospital nurses lasts for 8 hours, (Gordon, Cleary, Parker, & Czeisler, 1986; Labyak, 2002; Lee, 1992). Thus, it was recognized having importance that day and night shift nurses would have health issues depending on the shift work schedule and it seemed inevitable to perform studies on schedule work performance. Goal: The purpose of the study is to identify impacts on the health of night shift nurses, and identification of strengths and weaknesses of night shift work of nursesObjectives:1. To identify the initiative and work load of shift nurses,2. To identify the impact of shift work to health of shift nurses,3. To identify the strength and weaknesses of shift workMaterials and Methods: The research was performed on the basis of using Questionnaire, Focus group discussion and Checklists. Comparative research was done on the basis of P criteria; P if < Î.05 then it was estimated that possibility is correct. The research was performed through using software such as EXCEL 2007, SPSS.Results: The results of the research and studies are revealed that 28.3% of participants complained about fatigue, 22.5% of participants complained about having sleep disorder, 16.7 % of participants complained about having headaches, while according to the japans studies 21% of participants complained about fatigue, 29% of participants complained about having sleep disorder, 16% of participants complained about having backaches. Conclusions:1. The active conscience of shift nurses were studied and it was concluded that night shift nurses are less active (40%), and experiencing fatigue (53.3%) than day shift nurses. Also, it was observed that 53.3% of participants experienced heavy work load at day shift, while 41.7% of participants in the study experienced high load of work during night shift.2. The studies revealed that 73.35 of night shift nurses are experiencing fatigue, aches, have sleep disorder, headaches, foot aches, and stomachaches. Performing statistical comparison it was revealed that fatigue, aches, have sleep disorder had statistical probability at p< 0.05.3. The strength of night shift is in higher pay rate, which is higher than regular salary rate answered 75 % of participants, day off is longer answered 62.5 % of participants, while 69.2 % of participants answered that are experiencing general fatigue and 56.2 % of participants are having digestion problems.
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