Background: Peacekeeping operations (PKOs) demand not only high professional expertise but also immense physical and psychosocial endurance from military personnel. Comprehensively identifying the psychological health challenges and specific risk factors influencing combat stress is of paramount practical significance for maintaining unit combat readiness. Aim: This study aims to evaluate the changes in psychosocial health, personality traits, and underlying risk factors for combat stress among personnel during pre-deployment and active deployment phases. Materials and Methods: A prospective, two-phase longitudinal study was conducted during the pre-deployment training and the subsequent 6-month deployment in UNMISS, South Sudan. Data from 283 personnel who fully completed both phases were analyzed using SPSS via McNemar, Chi-square, Pearson correlation, and multivariable logistic regression. Result: Participants were predominantly male (92.9%) with a mean age of 28.9±5.8 years. During deployment, neurotic symptoms (33.9%), cognitive decline (15.9%), and sleep disturbances (15.2%) were highly prevalent. Female personnel demonstrated statistically significantly higher rates of neurosis, sleep disorders, and anxiety (p<0.05). Multivariable logistic regression analysis revealed that the presence of Post-Traumatic Stress Disorder (PTSD) symptoms significantly increased the risk of developing combat stress by 4.22 times (aOR=4.22, 95% CI: 1.36-13.16, p=0.013). Furthermore, a prior history of exposure to severe life stressors increased the odds of combat stress by 2.68 times (aOR=2.68, 95% CI: 1.01-7.11, p=0.048). Conclusion 1. During peacekeeping operations, service members most frequently encounter environmental and domestic challenges related to health, animals, and insects (44.2–44.5%). Furthermore, high rates of anxiety symptoms (>72.0%) and neurotic symptoms (33.9%, significantly higher in women, p<0.05) were reported. Consequently, personnel highly prioritize psychological resilience (59.0%) and teamwork skills (57.6%) in real-world deployment settings. 2. Logistic regression analysis demonstrated that the primary independent predictors increasing service members’ risk of exposure to combat stress are a personal history of severe life stressors (aOR = 2.68, p=0.048) and the presence of post-traumatic stress disorder (PTSD) symptoms (aOR = 4.22, p=0.013).

Background: Metabolic dysfunction–associated steatotic liver disease (MASLD) is a major cause of chronic liver disease and is increasingly linked to cardiovascular disease (CVD), the leading cause of mortality globally. Aim: To evaluate individuals participating in early screening using the Hepatic Steatosis Index (HSI) and examine its association with CVD risk levels. Materials and Methods: This population-based retrospective cross-sectional study included 47,542 adults aged 40–70 years who participated in a national screening program between 2023 and 2025. Hepatic steatosis was assessed using the Hepatic Steatosis Index (HSI) and categorized as <30 (no steatosis), 30–36 (indeterminate), and >36 (steatosis). Ten-year CVD risk was estimated using laboratory-based WHO cardiovascular disease risk charts for Central Asia. Associations were evaluated using logistic regression and expressed as odds ratios (ORs) with 95% confidence intervals (CIs). Result: The mean age of participants was 53.18±8.17 years, and 67.1% (31,886) were women. The prevalence of HSI <30, 30–36, and >36 was 8.9% (4,219), 32.1% (15,271), and 59.0% (28,052), respectively. The distribution of low-, moderate-, and high-risk CVD groups was 48.6% (23,115), 41.3% (19,637), and 10.1% (4,790), respectively. The proportion of individuals with high CVD risk was 5.5% in the HSI <30 group and 10.1% in the HSI >36 group. Compared with the reference group, the odds of high CVD risk were increased in the HSI 30–36 group (OR=1.333; 95% CI: 1.152–1.542) and the HSI >36 group (OR=2.401; 95% CI: 2.094–2.753). These associations remained statistically significant after adjustment for age, sex, systolic blood pressure, waist circumference, physical inactivity, and smoking. Conclusion The prevalence of hepatic steatosis in the study population was 59.0%. Individuals with hepatic steatosis had a 1.2-fold higher risk of cardiovascular disease compared with those without steatosis.

Background: Cancer is not only a physiological disease but also a complex condition that profoundly affects an individual’s psychological well-being and social relationships. Misconceptions about cancer within the public, including its association with death and the tendency to attribute blame to patients as being “personally responsible,” contribute to the development of social stigma among cancer survivors. This stigma negatively impacts patients’ engagement in treatment and their quality of life, highlighting the need to assess societal attitudes based on survivors’ lived experiences. Aim: To examine the everyday lived experiences of cancer survivors, measure perceived social stigma, and identify psychological challenges as well as sources of support. Materials and Methods: A mixed-methods design was employed. In the quantitative component, the Cancer Stigma Scale (CASS) and the Attitudes Toward Cancer Questionnaire (ATCQ) were translated and their content validity was evaluated by an expert panel using the Content Validity Index (CVI), followed by pilot testing to confirm feasibility (FVI). In the qualitative component, focus group discussions were conducted with cancer survivors, and coping ability was assessed using psychological assessment tools. Result: A total of 207 participants (68% female; mean age 33.82±13.7 years) were included in the quantitative study. Participants experienced a moderate level of cancer-related stigma, with negative attitudes most strongly associated with perceptions of disease severity and individual responsibility. Qualitative findings revealed that physician communication and family support played a decisive role in psychological responses at the time of diagnosis disclosure. Excessive sympathy or social distancing increased psychological distress, whereas normal interpersonal interaction and realistic encouragement were identified as the most effective forms of support. Conclusion To improve psychosocial support for cancer survivors, it is essential to enhance healthcare professionals’ communication skills, promote accurate public understanding of cancer, and strengthen the sustainability of survivor support group activities.

Background: Substance use remains a critical public health and social concern, closely linked to increased sexual risk behaviors and a heightened vulnerability to sexually transmitted infections (STIs), particularly HIV and syphilis. International and national evidence suggests that individuals who use drugs often experience impaired judgment during intoxication, leading to unprotected intercourse, casual sexual encounters, and multiple sexual partners. In Mongolia, empirical data regarding sexual risk behaviors within this population remain scarce. Therefore, there is a pressing need to determine the prevalence of sexual risk behaviors and identify the specific factors influencing these patterns among drug users. Materials and Methods: This study employed a cross-sectional analytical design involving 181 participants who use drugs. Data were collected via structured questionnaires. Sexual risk behavior was evaluated using two approaches: as a dichotomous categorical variable and as a cumulative sexual risk score. Statistical analysis was performed using frequency distributions, percentages, means, and standard deviations. The associations between variables were tested using the (chi square test, Pearson correlation analysis, and multiple linear regression models. Results: The findings revealed that 12.2% of participants exhibited high-level sexual risk behaviors, with a mean cumulative risk score of 8.13 ±4.40. Engaging in sexual intercourse while under the influence of alcohol, the frequency of intoxicated sex (reported as "often" or "always"), and a history of casual sexual encounters were significantly associated with sexual risk behaviors. Furthermore, gender, cohabitation status, condom use during the first sexual experience, and the frequency of alcohol-involved sexual encounters were statistically significant predictors of the cumulative risk score. A weak positive correlation was observed between the number of sexual partners in the past year and the cumulative sexual risk score, which remained a significant positive predictor in the linear regression model. Conclusion Sexual risk behavior among people who use drugs is more closely associated with behavioral factors—such as alcohol-influenced sexual activity, casual encounters, lack of condom use during sexual debut, and multiple partnership—than with basic socio-demographic characteristics. Consequently, risk reduction interventions should move beyond general awareness. Efforts must prioritize reducing substance- and alcohol-related sexual risks, promoting consistent condom use, and enhancing the accessibility of STI screening and counseling services tailored to this high-risk group.

Background: Drug use is closely associated with sexually transmitted infections, especially syphilis and HIV, through unsafe sexual practices, multiple partners, and high-risk patterns of substance use. Prisoners with a history of drug use represent a particularly vulnerable subgroup. Aim: This study aimed to determine the prevalence of rapid syphilis test positivity and selected associated factors among incarcerated people who use drugs. Materials and Methods: A cross-sectional analytic study was conducted among 105 prisoners. Data were collected using a structured questionnaire and a finger-prick rapid dual test. Descriptive statistics, chi-square tests, and Fisher exact tests were used, with p<0.05 considered statistically significant. Results: The mean age of participants was 29.1±8.4 years; 78.1% were male. A history of STI was reported by 16.2%, STI-related symptoms during the last 12 months by 19.0%, STI testing during the last 12 months by 39.0%, and STI testing while incarcerated by 45.7%. However, 79.0% had received STI-related education or information. Among 81 participants with valid rapid syphilis test results, 27 were positive, giving a prevalence of 33.3%. Syphilis positivity was significantly higher among those using more than one route of drug administration (41.4% vs 13.0%, p=0.018) and among those with a prior STI history (70.0% vs 26.6%, p=0.011). No significant associations were found with sex, age, education, marital status, cohabitation, income, syringe use, recent STI symptoms, casual sex before arrest, or overall sexual risk behavior. Conclusion These findings suggest that targeted syphilis screening, counseling, and linkage to confirmatory testing and treatment should be strengthened among incarcerated people who use drugs, particularly those with multi-route drug use and a previous STI history.

Background: Adolescence is a critical period for physical, psychological, and social development. However, traditional school bullying and cyberbullying have emerged as major public health issues adversely affecting adolescent mental health. Aim: To estimate the prevalence of school bullying and cyberbullying among Mongolian adolescents, evaluate their impacts on psychosocial difficulties, self-harm, and suicidal ideation, and identify protective factors. Materials and Methods: A cross-sectional study was conducted under the international Global Child and Adolescent Mental Health Study (GCAMHS) framework. A randomized sample of 2936 adolescents aged 11–17 years was recruited from public schools across Ulaanbaatar, provincial, and rural areas. Psychosocial difficulties were assessed using the Strengths and Difficulties Questionnaire (SDQ). Statistical analyses included Chi-square tests, independent t-tests, and multivariable logistic regression modeling to compute adjusted odds ratios (aOR). Results: Overall, 24.2% (n=710) of adolescents reported school bullying victimization, while 15.4% experienced cyberbullying victimization. Boys experienced higher rates of traditional school victimization than girls (28.5% vs. 20.4%, p < 0.001), whereas girls were significantly more vulnerable to cyberbullying victimization (17.4% vs. 13.1%, p=0.001). Bullied students showed significantly higher total SDQ difficulty scores compared to non-victims (18.08±6.15 vs. 10.86±5.20, p < 0.001). Multivariable logistic regression analysis revealed that cyberbullying victimization was the strongest predictor for suicidal ideation (aOR=3.62, 95% CI: 2.79–4.69) and self-harm behavior (aOR=3.08, 95% CI: 2.41–3.93). School bullying victimization also increased suicidal ideation (aOR=2.79), while school safety perception served as an independent protective factor against suicidal ideation (aOR=0.64, 95% CI: 0.53–0.76). Conclusion Traditional and cyberbullying remain prevalent among Mongolian adolescents, with cyberbullying exerting a particularly strong negative impact on psychosocial distress, self-harm, and suicidal ideation. Enhancing school safety and implementing targeted psychosocial and digital safety interventions tailored to gender-specific needs are essential.

Background: Suicide is a major global public health concern and one of the leading causes of death among adolescents. Mongolia’s suicide rate is approximately twice the global and regional averages. Suicide accounts for approximately one in four deaths among adolescents aged 15–19 years, while children and adolescents constitute a proportion of all suicide deaths in the country. Aim: To characterize the age- and sex-specific patterns of suicide deaths among children and adolescents aged 8–18 years in Mongolia from 2020 to 2024. Materials and Methods: A descriptive study was conducted using records of suicide deaths obtained from the database of the General Police Department of Mongolia. Cases involving children and adolescents aged 8–18 years registered between 2020 and 2024 were included. Descriptive statistical methods were used to analyze the distribution of cases by age, sex, and geographical location. Results: A total of 313 suicide deaths among children and adolescents aged 8–18 years were registered nationwide during 2020–2024. Of these, 67.4% occurred in rural areas and 32.6% in Ulaanbaatar. Boys accounted for 67.4% of cases, while girls accounted for 32.6%. The mean age at death was 15.15 years (SD, 2.35; range, 8–18 years). The highest number of cases was observed among adolescents aged 16–18 years. Conclusion Among the total number of deaths by suicide, the proportion of boys in late adolescence was high. Furthermore, two out of every three cases were recorded in rural areas.

Background: In Mongolia, the prevalence of non-communicable diseases and their intermediate risk factors has continuously increased in recent years. From results of early detection and prevalence studies of non-communicable diseases in Mongolia, studies linking intermediate risk factors to insulin resistance are scarce. Aim: To identify the prevalence of insulin resistance among the population and study its connection with intermediate risk factors of non-communicable diseases. Materials and Methods: This study was approved by the MNUMS Ethics Committee on February 23, 2024 (2024/3- 02), and was conducted based on the data of participants who took part in the “Population-based Preventive and Early Detection Screening of Infectious and Non-Infectious Diseases” organized by the Mongolian government from 2022 to 2023. Insulin resistance was identified using the triglyceride-glucose index (TyG), calculated by the formula Ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL) / 2]. “Ln” refers to the natural logarithm, based on Euler’s number, approximately 2.71828. TyG levels were classified into low risk (<8.5), medium risk (8.5-9.0), and high risk (>9.0). Defined intermediate risk factors for non-communicable diseases according to stages of hypertension and diabetes. Results: The mean age of participants was 44.3±15.2 years, with 39.2% (n=49,270) male and 41.4% (n=49,749) residing in urban areas. Among the participants, 59.1% had overweight or obesity, 23.6% had diabetes or impaired fasting glucose, 61.4% had hypertension, and 19.7% had elevated triglycerides. Analyzing by levels of insulin resistance risk, 62.8% of the population had low risk, 22.5% medium risk, and 14.7% high risk. Comparing systolic blood pressure across levels of insulin resistance risk showed that even without central obesity or diabetes, as the level of insulin resistance increased, the level of systolic blood pressure also increased (low risk group: 117.0±11.7, medium risk group: 121.1±10.9, high risk group: 123.5±16.2 mmHg). Regression analysis of the risk of hypertension by insulin resistance risk level showed that the risk increased with higher levels of insulin resistance (medium risk group OR=1.35, p<0.0001; high risk group OR=1.63, p<0.0001). Conclusion 22.5% of the population is at medium risk and 14.7% at high risk of insulin resistance. The increase in hypertension risk with higher insulin resistance levels is statistically significant, independent of central obesity and diabetes stages.

Introduction: Anemia is still being a population’s challenging issue regardless of high development of countries around the world. According to a study regarding prevalence and etiology of anemia conducted in 187 countries around the world, the anemia rate is 23 176 per 100 000 population. In accordance with the “5th National Nutrition Survey” study conducted in our country in 2017, one of every five women (21.4%), aged 15-49 years, (16.2%) of reproductive age women and (3.0%) of men are anemic. The current study was conducted due to it is still essential to study and identify the etiology of anemia, determine its prevalence, plan appropriate intervention, and organize future preventive measures, depending on the socio economic conditions, location, diet, and customs of the Mongolians. Aim: To determine the prevalence, red blood cell morphology, and severity of anemia among adults. Method: The cross sectional study was conducted during between May 2022 and Sep 2023 and adults aged above 18 years were included. Moreover, we identified anemia cases based on the laboratory test results and determined the anemia severity grade. Statistical analysis was performed by using SPSS software. Result: Overall, (6.7%) of participants were anemic: (9.9%) of women and (2.8%) of men. The distribution by severity was: mild anemia (66.7%), moderate anemia (30%), and severe anemia (3.3%). Among women of reproductive age, prevalence was higher, whereas in men, anemia prevalence increased with age. Regionally, the Central region showed the highest prevalence, while other regions varied. Analysis of anemia by red blood cell morphology showed that normocytic anemia accounted for (51.6%), hypochromic anemia 66%, and mean hemoglobin concentration hypochromic (53.6%). Moderate and severe anemia was more common in women than men. Conclusion Anemia was detected in (6.7%) of the total study population, (9.9%) of females, and (2.8%) of males were anemic. Of those with anemia, (66.7%) had mild anemia, (30%) had moderate anemia, and (3.3%) had severe anemia. Moderate and severe anemia were more common in females than in males.

Background: Obesity and metabolic disorders are significant contributors to hypertension and cardiovascular disease (CVD). While body mass index (BMI) and waist circumference are known to be associated with systolic blood pressure (SBP), the interplay between adiposity, glucose levels, triglycerides, and SBP is not fully understood. This study aims to investigate the relationships between BMI, waist circumference, glucose, triglycerides, and SBP in a large population-based cohort. Methods: A cross-sectional analysis was conducted on [insert total number] participants with complete data on BMI, waist circumference, blood pressure, glucose, and triglycerides. Descriptive statistics, ANOVA, Pearson correlations, mediation analysis, and multiple regression were used to explore the associations between variables. The moderation effect of glucose on the BMI-SBP relationship was examined using an interaction term in the regression model. Results: The mean age of the study population was 44.3 ± 15.2 years. The mean BMI was 26.7 ± 4.9 kg/m², and 22.7% of participants were classified as obese. Central obesity, measured by waist circumference, was prevalent in 55.9% of the population. BMI, waist circumference, glucose, and triglycerides were significantly associated with SBP (p < 0.0001). Mediation analysis showed that waist circumference partially mediated the effect of BMI on SBP. The interaction term for BMI and glucose was significant (β = 0.32, p < 0.05), indicating that glucose levels moderated the relationship between BMI and SBP, with higher glucose levels amplifying the hypertensive effect of BMI. Conclusion This study highlights the complex interplay between BMI, waist circumference, glucose, triglycerides, and SBP. Waist circumference partially mediates the effect of BMI on SBP, and glucose levels moderate this relationship, amplifying the impact of obesity on blood pressure.