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: 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: According to the World Health Organization (WHO), 99 percent of the world’s population is exposed to air that exceeds WHO recommendations, with low- and middle-income countries being the most affected. The main causes of indoor air pollution include human activities such as fuel burning, cooking, cleaning, and smoking; housing characteristics such as walls, floors, ceilings, and furniture; ventilation; and outdoor air pollution. Aim : To assess PM1 and PM10 concentrations in 120 selected households in Ulaanbaatar. Materials and Methods : Indoor PM1 and PM10 concentrations were measured using Purple Air real-time sensors in randomly selected Ulaanbaatar households between October 2023 and January 2024. Supplementary data on factors affecting the PM2.5 concentration were collected via questionnaires. Each measurement was taken in 10-minute intervals, yielding 51,309 data for analysis. Results : PM1 concentrations were measured at 55.5±53.2 μg/m³ in gers, 54.9 ± 46.7 μg/m³ in houses, and 31.6±40.1 μg//m³ in apartments (p<0.001) and measuring PM10 concentrations were 110.6±108.6 μg/m³ in gers, 110.6±96.7 μg/m³ in houses, and 62.2±83.0 μg/m³ in apartments (p<0.001) When considering the concentration of PM1, PM10 by heating type, PM1 was 55.3±50.1 μg/m³ and PM10 was 110.6±103.0 μg/m³ in households with stoves and furnaces, and PM1 was 31.6±40.1 μg/m³ and PM10 was 62.2±83.0 μg/m³ in households connected to the central heating system (p<0.001). Regarding the months of measurement, the highest concentration was observed in December 2023, at 77.1±94.1 μg/m³. The highest concentrations for both PM₁ and PM₁₀ were recorded in January 2024, at PM₁: 64.8±55.1 μg/m³, PM₁₀: 131.4±116.0 μg/m³. Conclusion 1. Indoor PM10 concentrations in residential environments in Ulaanbaatar city were within the MNS4585:2016 Air Quality Standard, however, it was exceeded the WHO air quality guidelines, indicating an excessive risk of increasing morbidity and mortality among the population. 2. Indoor PM1 and PM10 concentrations in residential environments in Ulaanbaatar varies depending on location, type of housing, type of heating, and month of measurement.

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.

Backround: The university period is a unique phase in students’ lives, often marked by independent living, changes in lifestyle, diet, sleep patterns, increased psychological stress, and the development of unhealthy behaviors. Among students, particularly those studying in the medical field, research on dietary habits and influencing factors is scarce in our country, which serves as the rationale for this study. Aim: The aim of this study is to investigate the dietary habits of medical students and the factors influencing them, including sleep, impulsivity, depression, anxiety, and stress. Materials and Methods: A cross-sectional study was conducted among 358 students from years 1 to 6 across 7 schools of the Mongolian National University of Medical Sciences (MNUMS). Data were collected using internationally standardized and validated questionnaires, including the Three-Factor Eating Questionnaire Revised-18 (TFEQ-R18), the Short UPPS-P Impulsive Behavior Scale-20 (SUPPS-P-20), the Depression, Anxiety, and Stress Scale-21 (DASS-21), and the Pittsburgh Sleep Quality Index (PSQI). Statistical analysis was performed using SPSS 25.0. Results: In terms of eating behavior, uncontrolled eating (UE) and cognitive restraint (CR) were similar between male and female students, while emotional eating (EE) was more prevalent among male students. Students’ eating behaviors were associated with body mass index (BMI). As BMI increased, levels of depression, anxiety, and stress also tended to rise. Sensation-seeking and positive urgency were higher among female students. Overall, 83.5% of students had poor sleep quality, which contributed to increased depression, anxiety, stress, and impulsivity. Psychological burden and impulsivity were independent of the field of study but decreased as students progressed through their academic years, while sleep quality improved. Conclusion The dietary habits of medical students were similar across genders but varied by academic year and field of study. Poor sleep quality, observed in 83.5% of students, was associated with increased depression, anxiety, stress, and impulsivity. Psychological burden and impulsivity were unrelated to the field of study but decreased with advancing academic years, alongside improved sleep quality. As BMI increased, cognitive restraint in eating behaviors decreased.

Background: Hepatitis virus infections are widespread and highly endemic in Mongolia and ranks first in the world for liver cancer mortality per 100,000 population, eight times the world average. The World Health Organization estimates that more than 2 billion people are infected with the hepatitis B virus. Each year, 1 million people die from the infection, 4 million are newly infected, and approximately 350-400 million are chronic carriers. In 2018, 475 cases of viral hepatitis were recorded nationwide, accounting for 1.1 percent of all communicable diseases, a decrease of 59 cases or 0.2 per 10,000 population compared to the previous year. In 2016, 194 WHO member countries joined forces to develop a strategy to reduce viral hepatitis, with the goal of reducing mortality by 65% and new infections by 90% by 2030. In order to achieve this goal, the strategic goal states that each country must conduct a comprehensive public health study and intervention on the spread of infection, risk factors, and early detection. Aim: Study to the coverage of hepatitis B immunization among children aged 0-9 years in urban and rural Mongolia and to determine the influencing factors. Materials and Methods: A Nationwide population based cross-sectional study design was used in this study. Mongolia is geographically divided into the western, Khangai, eastern, and central regions. A total of 14 provinces were selected randomly in addition to Ulaanbaatar city. The appropriate sample size was estimated at 4500 children aged 0-9 years, based on 2019 demographic data from the National Statistics Office. The questionnaire contained closed and semi-closed questions on demographics, socio-economic status, vaccination history and etc. Results: A total of 5027 children aged 0-9 years were enrolled in this study out of which 33.7% (n=1692) and 66.3% (n=3335) were enrolled from capital city Ulaanbaatar and provinces, respectively. Almost half (n=2552) of the study participants were boys whereas the remaining were girls 50.0% (n=2554). According to the history of Hepatitis B vaccination by questionnaire of parents’, 91.2% [91.2-92.0] were vaccinated with Hepatitis B. The proportion was 89.7% [89.7-90.8] and 94.1% [94.1-95.2] in rural and urban areas, respectively. Nearly 90% [89.6-90.5] of children were vaccinated in hospitals, 2.3% [2.0-5.0] were vaccinated at home, 8.1% [7.9-10.7] were unaware of the study participants’ location of vaccination. There were no statistically significant differences by urban and rural residences. Vaccination coverage against Hepatitis B was 91.5% (n=2300) and 90.9% (n=2284) among boys and girls, respectively and 89.6% (n=4506) were vaccinated at hospitals. Vaccination coverage were similar by sex. We also used Health Documents /pink book of children/ or vaccination card for each child to determine the coverage. According to the data from the children’s vaccination card and health documents’, 917 (18.2%) children were not vaccinated against hepatitis, 57 (1.1%) children received 1 dose, 235 (4.7%) children received 2 doses, and 3818 (75.9%) children received all 3 doses of hepatitis B vaccine. There was no significant difference by sex, though the coverage varied by age. For instance, proportion of children with no written documentation in the vaccination card was 13.5% among children aged 1 years that increased to 22.5% and 25.3% among children aged 8 and 9 years, respectively. In contrast the coverage rate of 3 doses of hepatitis B vaccination declined from 77.8% to 70.7% among children aged 1 years and 9 years, respectively. Hepatitis B vaccination coverage according to the vaccination card was different by provinces and within the districts of Ulaanbaatar city. Conclusion A total of 5027 children aged 0-9 years were included in the study, of which 917 (18.2%) children were not vaccinated against hepatitis, 57 (1.1%) children were vaccinated against the first dose, 235 (4.7%) children were vaccinated against the second dose, and 3818 (75.9%) children were fully vaccinated against the first-third dose. Although the coverage of the study participants varied depending on age and place of residence, no significant differences were observed in terms of gender. The current rate of children who are not fully vaccinated stands at 18.2%, emphasizing the need to ensure all children receive full vaccinations for hepatitis B and the required five doses as per the schedule. Furthermore, it is essential to mandate booster vaccinations for those with delayed immunizations and improve the accuracy of registration data.

Background: To effectively deliver healthcare services, it is necessary to strengthen and expand the education system for qualified biomedical equipment technicians and engineers. This should be combined with measures such as providing modern equipment to health facilities and making spare parts available. Internationally, there is a reference of one engineer responsible for 100 pieces of equipment. Additionally, one engineer is responsible for each major piece of equipment such as MRI, CT, positron emission tomography (PET SCAN), and angiography equipment. However, in our country, the standard is independent of the number of medical equipment. Although 4 universities nationwide train medical equipment engineers and technicians, they are unable to meet the growing market needs. Aim: To assess human resource needs for biomedical equipment specialists. Materials and Methods: We conducted the study using an analytical survey design. In the study, data were collected from a total of 272 engineers and technicians using a self-administered questionnaire that included years of work experience, post-graduate training, qualification level, and workload. The data were processed using SPSS Statistics 26 software, and the results were presented in figures, tables, and sentences. Results: Of the professionals surveyed, 72.4% were male, 95.6% were full-time employees, and 68.8% had a bachelor’s degree. However, the majority (90.4%) of the professionals did not have a professional degree. When asked about the availability of on-the-job and other training among the professionals 73.5% had not received any training at all. The level of training received by professionals did not depend on the organization they worked for. However, there was a statistically significant difference between the level of training received from foreign and manufacturer-sponsored organizations. The professionals surveyed had relatively little training since they started working. As the number of years of experience in their profession increased, the number of times they participated in manufacturer-sponsored training increased. However, the number of times they participated in domestic, foreign, or postgraduate training was not related to the number of years of experience. Conclusion Medical equipment engineers and technicians are working harder than international professionals. The lack of post-graduate training for healthcare professionals is a concern for the industry.

Background: According to the World Health Organization (WHO), 6.7 million people die annually due to air pollution caused by solid fuel use, with the majority of deaths resulting from respiratory diseases and cardiovascular conditions. In Mongolia, air pollution ranks as the fourth leading risk factor contributing to mortality, following hypertension, diabetes, and other major health risks. Although there have been numerous studies on outdoor air pollution in Mongolia, research linking indoor air pollution at the household level with the health status of residents remains limited. Aim: To compare indoor PM2.5 concentrations in households of Ulaanbaatar and Darkhan and examine their association with hypertension during the winter season. Materials and Methods: The study was conducted during November and December 2023, and January 2024, involving 240 households in Ulaanbaatar and Darkhan. Indoor PM2.5 concentrations were measured using Purple Air real-time sensors continuously for 24 hours over approximately one month. After measuring indoor air pollution, individuals aged 18–60 years living in the selected households were recruited based on specific inclusion criteria. Blood pressure was measured three times and the average value was recorded. Information on respiratory illnesses was collected through structured questionnaires. Statistical analysis was performed using STATA version 19.0. Results: A total of 241 households participated in the study, with 116 from Ulaanbaatar and 125 from Darkhan. Of the participants, 46.5% were male and 53.5% were female. In terms of housing type, 96 households (39.8%) lived in gers, 97 (40.2%) lived in stove-heated houses, and 48 (19.9%) lived in apartments. Among all participants, 66.0% (n=159) had hypertension and 34.0% (n=79) had normal blood pressure. Among participants aged over 40, 69.9–88.5% had hypertension, which is statistically significantly higher compared to younger individuals (p=0.0001). By body mass index, 75.3% (n=72) of overweight individuals and 78.4% (n=58) of obese participants had hypertension, showing a statistically significant difference compared to participants with normal weight (p=0.0001). The 24-hour average concentration of indoor PM2.5 was measured using the Purple Air device, and the levels in gers and stove-heated houses exceeded the limit set by the MNS 4585:2025 standard (37.5 µg/m³) Conclusion This study identified a relationship between environmental factors, such as air pollution and housing type, and the prevalence of hypertension. The indoor PM2.5 concentration in gers and stove-heated houses was above the standard limit, indicating a negative impact on the health of those residents. Furthermore, the high prevalence of hypertension among participants over the age of 40 and those who are overweight suggests a possible link to lifestyle and environmental conditions.

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.