Background: Although food-borne infectious diseases occur across all age groups globally, evidence indicates that young children, older adults, and immunocompromised individuals are disproportionately affected due to their increased susceptibility to enteric pathogens. Young children in particular are at higher risk because their immune systems are not yet fully developed and they have lower body mass, which together reduce their ability to resist and recover from food-borne infections. In Mongolia, reported cases of intestinal infectious diseases in 2024 exceeded the ten-year historical average by 504.5 cases, and food- and water-related infections such as hand-foot-and-mouth disease, dysentery, and salmonellosis remain predominant among these conditions. Aim: The objective of this study was to conduct microbiological analyses of school lunches and drinking water provided to general education school students and to evaluate their compliance with relevant national standards. Materials and Methods: A total of 107 school lunch samples and 35 drinking water samples collected from general education schools were included in the study. Microbiological analyses were performed to assess hygiene and safety indicators, including Listeria monocytogenes, Salmonella spp., total coliform count, total viable microbial count (TVC), and intestinal bacteria. Laboratory analyses were conducted at the Microbiology Laboratory of the Food Safety Reference Laboratory under the Standardization and Metrology Authority. Confirmatory identification of microorganisms was performed using the VITEK 2 Compact system. Result: Of the 35 drinking water samples analyzed for 105 parameters, 8.5% (n=3) exceeded the permissible limits for total microbial counts. In the 107 school lunch food samples, a total of 428 microbiological parameters were examined, of which 26.1% (n=28) showed coliform counts above the allowable limits specified in the MNS 6308:2012 standard. Additionally, enterobacteriaceae were detected in 42.9% (n=46) of the food samples. When analyzed by school, 51.5% of the 35 schools (18 schools) had food samples with coliform counts that did not meet the standard requirements, whereas 49.5% (17 schools) showed compliance with the standards. These findings indicate that, on average, one out of every two schools fails to meet the required hygiene practices, proper food production procedures, and microbiological safety standards in meal preparation. Conclusion Microbiological analysis of 107 food samples from 35 general education schools across 428 indicators revealed that 26.1% did not meet the requirements of the MNS 6308:2012 “Microbiological safety and hygiene criteria for food products” standard due to excessive coliform counts. Of the 35 drinking water samples analyzed for 105 indicators, 5.7% (n=2) failed to meet the requirements of the MNS 0900:2018 “Drinking water: Hygiene requirements, quality, and safety assessment” standard with respect to total viable microbial count.

Background: Aetiological mechanisms of demyelinating diseases underlie a very heterogeneous clinical course, ranging from relapsing to progressive, with a longer disease duration leading to physical and cognitive disability. Aim: To identify factors in the development of long-term disability in demyelinating diseases. Materials and Methods: A cross-sectional study was conducted among 64 patients with multiple sclerosis and 33 patients with NMO treated at the Third State Central Hospital. We assessed demographic and clinical data, including the Expanded Disability Status Scale (EDSS). Statistical analysis included descriptive statistics, t-tests, chi-square tests, analysis of variance, correlation, and regression. Result: In MS, relapses (≥1) within 1.0 years of MS onset (OR=5.5, 95% CI 1.11-26.69, p=0.037), optic neuritis (OR=4.3, 95% CI 1.02-21.67, p=0.014), relapse frequency (≥3) (OR=6.6, 95% CI 1.39-31.3, p=0.018), myelitis frequency (≥2) (OR=5.5, 95% CI 1.42-21.67, p=0.014), in NMOSD, time from disease onset to diagnosis (≥3 month) (OR=7.9, 95% CI 1.04-60.7, p=0.046), years of diagnosis (≥3 years) (OR=6.3, 95% CI 1.15-34.12, p=0.034) contributed to disabilty worsening outcomes. Conclusion Disability in demyelinating diseases is affected by many factors.

Background: Numerous studies have shown that air pollution is a serious public health threat and risk worldwide. Mongolia is the world leader in outdoor and indoor air pollution, and the morbidity and mortality caused by it are increasing every year. People spend most of their lives indoors, and it is necessary to regularly assess and study indoor air pollution. Aim: To study the concentration of PM2.5 particles in the indoor air of households in Ulaanbaatar and Darkhan cities in relation to some symptoms of respiratory diseases. Materials and Methods: The study was conducted using an analytical cohort design from October 2023 to July 2025, and the 4 districts of the central Ulaanbaatar city and Darkhan cities were included in the study. A total of 240 households were included in the study, including 48 households living in ger and house, 24 households living in apartments, and 48 households living in ger and house, and 24 households living in apartments from Ulaanbaatar city. A direct measurement device (PurpleAir) was installed in the households for 3-4 weeks to measure PM2.5 particles in the indoor air for 24 hours. After measuring PM2.5 particles in the indoor air of the household, data were collected through questionnaires from the participants aged 18-60 who participated in the study and underwent health examinations. The results were processed using STATA-19.0 and R programs. Result: 213-239 households were selected for the study, including households living in 17-26 apartments, 42-58 houses, and 38-50 houses. The 24-hour average concentration of PM2.5 particles in the ambient air of households in Ulaanbaatar city was measured relatively higher in winter and summer than in households in Darkhan city. Among the districts of Ulaanbaatar city, the highest concentration of PM2.5 particles was measured in Songinokhairkhan district, and the lowest concentration was measured in Bayanzurkh district. Considering the cities by heating type, households with stoves are more polluted than households with centralized heating. In Darkhan city, the lowest concentration was measured in apartments (22.78-31.53 μg/m³), houses (44.53-68.17 μg/m³), and the highest concentration was measured in traditional felt houses (houses) (63.20-68.25 μg/m³). In Ulaanbaatar, PM2.5 concentrations were relatively high in all types of housing, including apartments (41.61-58.37 μg/m³), houses (79.22-92.50 μg/m³), and traditional felt dwellings (76.69-86.31 μg/m³). In the summer, PM2.5 concentrations in Darkhan were 3.10-10.03 μg/m³ in apartments, 7.67-14.37 μg/m³ in houses, and 7.98-17.90 μg/m³ in traditional felt dwellings (houses). The concentration of PM2.5 particles in the ambient air of the settlement is statistically significantly associated with shortness of breath, fatigue, weakness, muscle pain, nausea, palpitations, sneezing, runny nose, conjunctivitis, pain in the eye socket, tearing of the eyes, headache, fever, nasal congestion, cough, loss of appetite, sore throat, phlegm, wheezing, and chest pain. Conclusion The 24-hour average concentration of PM2.5 particles in indoor air in households in Ulaanbaatar and Darkhan cities is higher than the Mongolian standard during winter and is statistically significantly associated with some symptoms of respiratory diseases.

Background: Ambient and household air pollution remain leading risk factors for global morbidity and mortality. Exposure to fine particulate matter (PM₂.₅) is associated with increased risks of cardiovascular and respiratory diseases, as well as lung cancer, metabolic and neurological disorders, and immune dysfunction. In urban areas of Mongolia, air pollution reaches critical levels during the winter season. Although improved solid fuels have been introduced in recent years, their impact on both outdoor and indoor air quality remains insufficiently characterized. Aim: To compare outdoor and household air pollution levels in Ulaanbaatar and Darkhan cities. Materials and Methods: Outdoor air pollution data for Ulaanbaatar were obtained from fixed monitoring stations of the National Agency for Meteorology and Environmental Monitoring for the period 2014–2026, with seasonal comparisons performed. For indoor air quality assessment, a longitudinal study was conducted among 240 households (apartments, houses, and traditional gers) in Ulaanbaatar and Darkhan from 2023 to 2026. PM₂.₅ concentrations were measured using real-time sensors (PurpleAir sensor), deployed for 14–21 days per season (winter and summer) in each household, recording data at 10-minute intervals over 24-hour periods. Result: Between 2014 and 2026, the 24-hour mean concentrations in Ulaanbaatar were 60.5 µg/m for PM₂.₅, 117.3 µg/m for PM₁₀, 37.3 µg/m for NO₂, 41.8 µg/m for SO₂, and 27.5 µg/m for O₃. While particulate matter levels showed a decreasing trend following the introduction of improved fuels, SO₂ concentrations increased, and overall pollution levels remained higher than those observed in Darkhan. Indoor PM₂.₅ concentrations were higher in Ulaanbaatar compared to Darkhan (60.7±86.1 vs 48.4±96.7 µg/m). Significant differences were observed by housing type (p<0.0001), with higher concentrations in households using solid fuels (houses and gers) and lower levels in apartments. These findings indicate substantial variability in indoor air pollution by city, housing type, and season, with persistently elevated exposure levels. Conclusion Outdoor air pollutant concentrations in Ulaanbaatar, including particulate matter, NO₂, and SO₂, exceed national standards and WHO guideline values by 1–4 times. Indoor PM₂.₅ pollution is higher in Ulaanbaatar than in Darkhan and varies significantly by housing type and season, indicating a high and heterogeneous exposure burden among urban populations.

Background: Inflammatory bowel disease (IBD) is a chronic immune-related condition caused by interactions between genetics, immune dysfunction, gut microbiota changes, and environmental factors, often presenting as persistent or recurring diarrhea. Clinically, it commonly presents with chronic diarrhea and other gastrointestinal symptoms. The global prevalence of IBD is increasing, currently affecting approximately 0.5% of the population, with projections suggesting a rise to nearly 1% by 2030. Fecal calprotectin is a neutrophil-derived S100 calcium-binding protein that is elevated in intestinal mucosal inflammation and serves as a reliable noninvasive biomarker of inflammatory activity. Due to its high stability and close association with intestinal inflammatory activity, fecal calprotectin has been established as a dependable, non-invasive marker for identifying intestinal inflammation. In clinical practice, it is extensively used to distinguish IBD from functional gastrointestinal disorders, especially irritable bowel syndrome, among patients presenting with chronic diarrhea. However, its diagnostic utility in Mongolia remains underexplored, and this study aims to determine its sensitivity and specificity in inflammatory bowel disease and compare its diagnostic performance with other inflammatory markers. Aim: To determine the sensitivity and specificity of fecal calprotectin in inflammatory bowel disease and to compare it with other inflammatory markers. Materials and Methods: A total of 109 participants aged 18-87 years with chronic diarrhea, who attended the gastroenterology outpatient clinics of the Mongolia–Japan Hospital and Intermed Hospital between December 2024 and December 2025 and provided informed consent, were enrolled in this study. Data were collected using structured questionnaires, and laboratory investigations included complete blood count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and measurement of fecal calprotectin levels from stool samples. Based on fecal calprotectin results, selected participants underwent colonoscopic examination as clinically indicated. Results: Among the 109 participants included in the study, 17.4% were diagnosed with inflammatory bowel disease (IBD), with a mean age of 47.41±15.52 years. Fecal calprotectin levels were significantly higher in the IBD group compared to the control group (p<0.001). Fecal calprotectin demonstrated a weak positive correlation with C-reactive protein (CRP) and leukocyte count (p=0.042, p=0.06), while no significant correlation was observed with erythrocyte sedimentation rate (ESR). At a cutoff value of 250 µg/g, fecal calprotectin showed a sensitivity of 94.4%, specificity of 69.2%, positive predictive value (PPV) of 37.8%, and negative predictive value (NPV) of 98.4%. Receiver operating characteristic (ROC) curve analysis identified an optimal cutoff value of approximately 400 µg/g (AUC=0.919, Youden index=0.724), at which the sensitivity remained 94.4% and specificity increased to 78.0%. In contrast, CRP and ESR demonstrated comparatively lower diagnostic performance, with AUC values of 0.640 and 0.644, respectively. Conclusion This study demonstrates that fecal calprotectin has superior diagnostic performance compared to conventional inflammatory markers in differentiating inflammatory bowel disease (IBD). An optimal cutoff value of approximately 400 µg/g yielded the highest sensitivity and specificity. Therefore, fecal calprotectin may serve as a valuable tool in clinical practice for both screening and diagnostic confirmation.

Background: Transitioning HIV care toward a client-centered model is a key strategy for improving treatment outcomes and controlling the spread of HIV infection. Evaluating service accessibility, quality, and client satisfaction is essential for improving strategic planning and strengthening health service delivery. Aim: To assess the accessibility and quality of client-centered health services among people living with HIV. Materials and methods: A facility-based cross-sectional study was conducted. Data were collected using structured questionnaires from 50 clients and 30 health managers who participated voluntarily. The reliability of the questionnaire, measured using Cronbach’s alpha, ranged from 0.673 to 0.783. Data were analyzed using SPSS version 23.0 with both descriptive and analytical statistical methods. Quantitative variables were summarized using means and standard deviations, and statistical significance was determined at p < 0.05. Results: HIV-related services were found to be highly centralized at the NCCD, particularly for blood testing (96.8%) and inpatient care (71.4%). Overall, 84% of clients reported the need to access services outside NCCD, with the highest demand for internal medicine (32%), dental services (14%), and surgical services (14%). Among the barriers to accessing care, 75% were related to stigma and discrimination associated with HIV status, while 18% were linked to healthcare workers’ attitudes. In addition, 56.7% of healthcare facilities had not conducted HIV-related training, and only 40% had dedicated rooms ensuring confidentiality. Client satisfaction was strongly correlated with healthcare providers’ attitudes and communication (R = 0.614) and confidentiality (R = 0.578), both showing significant associations (p = 0.000). Conclusion HIV services remain highly centralized at NCCD, while the readiness of primary and referral healthcare facilities remains insufficient. Strengthening a client-centered care approach requires improving healthcare workers’ attitudes and communication, ensuring confidentiality, and implementing continuous HIV-related training for healthcare providers.

Background: Temporomandibular disorders (TMD) are the most common cause of non-dental orofacial pain and affect about one-third of adults. Population-based data obtained with standardized criteria are scarce in Mongolia, particularly outside the capital. Aim: To determine the prevalence of clinical signs of TMD and of examination-based Diagnostic Criteria for TMD (DC/TMD) diagnoses among residents of western Mongolia, and to compare them by sex and age group. Materials and Methods: This retrospective secondary data analysis utilized research data collected in 2020–2021 across Bayan-Ulgii, Govi-Altai, Zavkhan, Uvs, and Khovd aimags. A total of 520 participants were included in the analysis; participants aged from 16 to 71 years, with females accounting for 72.3%. Ethical approval for the secondary use of data was obtained in 2024. Diagnoses that can be established from the examination alone (IIa, IIIa–IIIc) were assigned. Differences were tested with chi-square and Fisher’s exact tests and logistic regression. The study was approved by the MNUMS Research Ethics Committee (№24/3-06) Results: At least one clinical sign was found in 87.1% of participants; deviation on opening (58.1%) and joint sounds (56.2%) were the most common. Muscle and joint pain on opening were found in 16.7% and 18.3%, and muscle and joint pain on palpation in 8.7% and 8.3%, respectively. An examination-based diagnosis was established in 21.5% (95% CI 18.2–25.3); disc displacement with reduction (14.4%) was the most common and Group III diagnoses were found in 8.3%. Pain on palpation at three or more muscle sites was found in only 3.3%. Compared with men, women more often had joint pain on opening (21.0% vs 11.1%; p=0.009) and muscle and joint pain on palpation, and had 2.5-fold higher odds of a Group III diagnosis (OR 2.50; 95% CI 1.02–6.15). Muscle pain on opening decreased with age (from 26.7% to 10.6%; p=0.036), whereas diagnoses did not differ by age group. Conclusions Most residents of western Mongolia had at least one clinical sign of TMD, mainly deviation on opening and joint sounds, and one in five had an examination-based DC/TMD diagnosis. Painful joint conditions were more common in women. The low prevalence of myofascial pain should be interpreted in light of limited standardization of palpation.

Background: Nutritional status among university students is a critical public health issue. Students often face undernutrition or overeating due to social, cultural, and academic pressures. This study aimed to assess the dietary habits and health behaviors of students at Inner Mongolia Medical University to inform targeted intervention strategies. Aim: To examine the differences in dietary patterns among students and their effects on health outcomes. Materials and Methods: A cross-sectional study was conducted among 218 students (133 males, 85 females; ages 19–24) from the 3rd to 5th year of the Clinical Medicine program. Participants were randomly selected. Data were collected via a structured questionnaire based on the “Chinese Resident Dietary Guidelines (2022)” and relevant domestic and international literature. Variables included demographic information, dietary intake (fruits, vegetables, fats, starches, sugar, salt, water, alcohol, dairy), and physical activity patterns. Data were analyzed using SPSS 26.0, with frequencies and percentages for categorical variables and means ± SD for continuous variables. Results: The 87.61% of students consumed fruits and vegetables daily, but only 73.39% met the recommended five types per day. The main barriers were limited availability (51.38%), high cost (31.65%), and lack of preparation time (16.97%). 67.89% preferred low-fat foods; 47.25% used vegetable oil, 22.94% butter, 22.02% margarine; daily fat consumption averaged 1–2 tablespoons. 77.98% consumed fried or roasted foods. 53.21% consumed sugar-rich products at breakfast; 62–64% added sugar to beverages or consumed sweetened snacks; high salt intake was common through processed foods. The 36.24% exercised once per week, 25.69% twice; only 10.09% exercised four or more times per week. 68.81% consumed alcohol at varying frequencies; beer, red wine, and white wine were common. Over half of students were at risk of high blood pressure due to dietary and lifestyle factors. Conclusion Students at Inner Mongolia Medical University face significant dietary challenges, including unbalanced diets, high sugar and salt intake, irregular meals, and inadequate physical activity. There is an urgent need for personal and institutional interventions to promote healthy dietary and lifestyle habits.

Backgroun: Air pollution is a major global public health concern that poses serious risks to human health regardless of a country’s level of economic or technological development. According to the World Health Organization (WHO, 2021), nine out of ten people worldwide breathe polluted air, and air pollution is responsible for the deaths of approximately 800 people every hour and 13 people every minute. Prolonged exposure to polluted air has been linked to a wide range of chronic illnesses, including chronic obstructive pulmonary disease (COPD), lung and bronchial cancers, asthma, and stroke. In Mongolia, air pollution reaches its highest levels during the winter months, particularly in Ulaanbaatar, where the majority of the country’s population resides. A study conducted by Enkhjargal G. (2012) reported that the concentrations of PM10 and PM2.5 in Ulaanbaatar were 7–8 times higher than the WHO recommended guidelines. In response to such challenges, many countries have increasingly adopted low-cost, direct measurement devices such as PurpleAir to monitor air quality. These devices are valued for their accessibility, network connectivity, and potential role in smart city pollution management systems. Despite their global application, there remains a lack of research in Mongolia on the use of PurpleAir sensors to measure PM2.5 concentrations and compare the results with official monitoring station data. Addressing this gap is essential for improving local air quality monitoring capacity and informing effective public health and environmental policies. Aim: Determination of PM2.5 particulate matter pollution in the outdoor environment of Ulaanbaatar city using a direct measurement device (Purple Air). Materials and Methods: A cross-sectional study design was employed. Direct measurement devices (Purple Air) were installed in selected districts of central Ulaanbaatar between December 2024 and February 2025, measuring PM2.5 concentrations at two-minute intervals over 24-hour periods. All data were statistically processed and analyzed using the SPSS-26 software package. Results: The average concentration of PM2.5 particles in the air of Ulaanbaatar city in winter is 66.68 μg/m3. Compared to the districts, the highest concentration was determined in SKHD (118.58±90.22 μg/m3), while the lowest concentration was determined in KHUD (42.37±43.51 μg/m3). Compared to the days of the week, the highest concentrations were measured on Monday (76.68±71.98 μg/m³), Saturday (77.50±71.63 μg/m³), and Sunday (80.34±74.45 μg/m³). The highest concentration of PM2.5 particles occurred from 6 pm to 1 am, and the lowest concentration was measured during the day (between 2 pm and 4 pm). The highest concentration of PM2.5 was measured in December (74.22±73.45 μg/m3), while the lowest concentration was measured in February (50.25±57.44 μg/m3). Conclusion The concentration of PM2.5 in the air of Ulaanbaatar city is 1.7 times higher than the general standard and technical requirements of Mongolia in winter, and the highest concentration is in the SKHD. The highest concentration of PM2.5 occurs more often in December and at night than in the winter months.

Background: Particulate matter with an aerodynamic diameter of 2.5 micrometers or smaller (PM2.5) penetrates deep into the alveoli through the respiratory tract and is characterized by its ability to induce oxidative stress, systemic inflammation, and vascular inflammation. Mongolia ranks among the countries with the highest levels of air pollution. In Ulaanbaatar, where more than half of the country’s population resides, wintertime PM2.5 concentrations often exceed 200 μg/m³, which is about eight times higher than the World Health Organization (WHO) guideline value. A study involving 1,200 adults in Ulaanbaatar showed that quality of life deteriorated sharply during periods of high air pollution, with effects more pronounced among individuals who already had impaired respiratory function. Aim: To examine the relationship between indoor household PM2.5 concentrations and lung function indicators among adults in Ulaanbaatar and Darkhan. Materials and Methods: This analytical cross-sectional study recruited adult participants from Ulaanbaatar and Darkhan through targeted sampling. Household air quality was measured using PurpleAir sensors, which were installed in participants’ homes for one month. After exposure measurement, lung function was assessed via spirometry. Statistical analyses were conducted using SPSS version 25.0. Results: A total of 236 participants were included: 114 (48.3%) from Ulaanbaatar and 122 (51.7%) from Darkhan. The sample consisted of 111 men (47.0%) and 125 women (53.0%). The mean indoor PM2.5 concentration was 66.24 μg/m³ (SD 44.87 μg/m³), ranging from a minimum of 7.79 μg/m³ to a maximum of 264.55 μg/m³. Stratification by housing type showed the highest PM2.5 levels in gers (82.34 μg/m³), followed by detached houses (67.34 μg/m³), while apartments had the lowest concentrations (32.24 μg/m³). Correlation analysis revealed statistically significant negative associations between PM2.5 levels and measures of expiratory function, including the FEV1/FVC ratio, peak expiratory flow (PEF), and mid-expiratory flow (FEF25–75). Reduced forced vital capacity (FVC) was observed in 9.4% of participants, reduced forced expiratory volume in one second (FEV1) in 15.3%, and a decreased FEV1/FVC ratio in 3.8%. Conclusion Indoor household PM2.5 concentrations were highest in gers, and expiratory flow-related lung function parameters showed significant negative associations with particulate exposure. This suggests that indoor PM2.5 primarily affects airflow limitation rather than overall lung volumes in this population.