1.Assessment of diagnostic delay and direct costs among hospitalized patients with tuberculosis
Altanchimeg B ; Purevsod L ; Munkhzul B ; Oyungerel R ; Gantugs Yu
Mongolian Journal of Health Sciences 2026;96(6):116-120
Background:
Tuberculosis (TB) remains a major public health concern worldwide and continues to be a leading cause of morbidity and mortality. Delays in diagnosis and care seeking exacerbate disease severity and increase financial burdens on healthcare systems and patients. In Mongolia, comprehensive evidence on diagnostic delays and direct hospitalization costs for TB patients remains limited.
Aim:
To evaluate the duration of diagnostic delay and estimate direct medical costs incurred during hospitalization among TB patients, as well as to identify associated factors.
Materials and Methods:
A retrospective cross-sectional study was conducted using medical records of 285 newly diagnosed TB patients hospitalized at the National Center for Communicable Diseases (NCCD) in 2024. Statistical analyses were performed using SPSS version 26 and MS Excel. A p-value of <0.05 was considered statistically significant.
Result:
The mean age of participants was 42.6±16.0 years, and 56.5% (n=161) were male. Median patient delay was 14 days (IQR: 5–31), median diagnostic delay was 4 days (IQR: 0–14), and mean hospital stay was 21.0±16.0 days. Median direct costs per patient were: diagnostic cost 262.0 thousand MNT (IQR: 187.0–363.0), treatment cost 490.9 thousand MNT (IQR: 234.4–884.1), and total cost 761.7 thousand MNT (IQR: 460.4–1247.6). Multivariate linear regression revealed that patient delay >14 days was significantly associated with higher total costs (=659.333, p=0.004).
Conclusion
1. The median patient delay among patients with tuberculosis was 14 days (IQR, 5–31), while the median diagnostic delay was 4 days (IQR, 0–14). Overall, 61.6% of patients experienced patient delay, and 63.5% experienced diagnostic delay.
2. The median total direct medical cost among hospitalized patients was 761.7 thousand Mongolian Tugriks (MNT). A patient delay of more than 14 days was significantly associated with increased total direct medical costs (β=659.333, P=.004).
2.Factors associated with complications and recurrence of erysipelas
Purevsod L ; Nomin B ; Khorolgarav G ; Davaakhuu B ; Oyungerel R ; Baatarkhuu O ; ; Nyamtsengel V
Mongolian Journal of Health Sciences 2026;94(4):37-42
Background:
Erysipelas is an acute, recurrent infectious disease caused by Group A β-hemolytic streptococcus. Recurrence occurs in 12–29% of patients, and complications in approximately 31%. International studies indicate that age, sex, and skin conditions are key factors influencing complications and recurrence. In Mongolia, the incidence of erysipelas has not steadily declined, and there is a lack of studies investigating clinical and laboratory predictors of complications and recurrence.
Aim::
This study aimed to investigate clinical and laboratory predictors of complications and recurrence among erysipelas cases registered in Mongolia.
Materials and Methods:
A retrospective cross-sectional study design was employed. A total of 165 patients hospitalized with a diagnosis of erysipelas at the National Center for Communicable Diseases between 2020 and 2024 were randomly selected. Data were collected based on the “Clinical Guidelines for Erysipelas.” Statistical analysis was performed using SPSS-26, and ROC curve analysis along with regression models were used to determine risk and predictive factors. A p-value <0.05 was considered statistically significant.
Results:
The mean age of participants was 50.4±14.2 years; 76.5% were female, and 32.1% were herders. Recurrence was observed in 55.1% of patients (42.8% repeated episodes, 57.2% recurrent cases), and complications occurred in 10.3%. Among patients with complications, lesions were most commonly located on the face (41.2%) and predominantly presented as erythematous-bullous forms (70.6%). The neutrophil-to-lymphocyte ratio was 7.1 (AUC: 0.85, 95% CI: 0.79–0.91, p=0.001), and the systemic inflammatory response index was 3.9 (AUC: 0.93, 95% CI: 0.88–0.98, p=0.001), indicating high levels. Multivariable regression analysis showed that risk factors for complications included age >45 years (aOR=1.8, 95% CI: 1.2–2.7, p=0.004), female sex (aOR=2.8, 95% CI: 1.7–4.6, p=0.001), and occupation (herder) (aOR=2.6, 95% CI: 1.3–5.4, p=0.001). Chronic tonsillitis was significantly associated with recurrence (OR=3.8, 95% CI: 2.5–5.7, p=0.001). Cox regression analysis demonstrated that each additional year of age increased the risk of complications by 2% (HR=1.02, 95% CI: 1.01–1.03, p=0.003), while the presence of chronic tonsillitis increased the risk of recurrence by 7.69 times (HR=7.69, 95% CI: 5.15–11.49, p=0.001).
Conclusion
Cellular ratio indicators in erysipelas are useful for assessing inflammatory activity and disease progression. Age, sex, occupation, and the presence of chronic tonsillitis significantly influence the risk of complications and recurrence in erysipelas.
Result Analysis
Print
Save
E-mail