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Introduction@#Mongolia’s capital hosts about half the country’s total population, and its air pollution ranks among the highest in the world during winter. Air pollution is linked to reduced fetal growth, preterm birth, low birth weight, impaired cognitive intra-uterine development, impaired cognitive development, and even spontaneous abortion. Antenatal care includes fetal development monitoring, prevention of anemia, immunization against infectious diseases, prevention of sexually transmitted diseases, and any health risk factors such as environmental pollution. </br>Health care measures for pregnant women and children under one year of age have the potential to be highly effective because they are directly aimed at reducing pneumonia in children. As such, we need to conduct this survey to determine whether pregnant women were satisfied with the information and advice on air pollution prevention provided by health facilities and to take evidence-based measures.@*Materials and Methods @#The survey data were collected using quantitative and qualitative research methods. In this study, a total of 958 pregnant women participated from Songinokhairkhan district, Bayanzurkh district, and Bayankhongor province center. The overall satisfaction of health services is calculated using the three dimensions namely: satisfaction with health service, operation, and environment of the Health Organization. Satisfaction scores were assessed using an even-point scale. These are “Very Dissatisfied-1 point”, “Dissatisfied-2 point”, “Satisfied-3 point”, “Very satisfied-4 point”. The results were calculated after entering the survey data into SPSS-23, creating a database, and performing error control. The research methodology was discussed at the meeting of the Academic Council of the National Center for Public Health on December 25, 2019, and the methodology was approved by the Medical Ethics Committee of the MOH (Stagnant №2).@*Results @#The survey covered 958 pregnant women aged 16-45 in Bayanzurkh district Songinokhairkhan district, and Bayankhongor province. During antenatal care visits, the majority of pregnant women (BZD- 56.9%, SKHD- 68.3%, BKH province - 86.7%) were advised by their health specialists to go outside for fresh air, while women in Ulaanbaatar (BZD- 18.9%, SKHD- 24.7%) received the information and advice at the lowest percentage. Pregnant women in Ulaanbaatar were less involved in air pollution training than in Bayankhongor. Participants in the air pollution prevention training rated it as “satisfied” regardless of location. 37.2% of pregnant women obtained information on protecting their health from air pollution from the board of Family Health Center and 34% from their district health centers. 86.1% of the participants were able to obtain information on air pollution on their own, while 86% of them got information from their family and friends. @*Conclusion @#The percentage of pregnant women getting medical advice, training, and information on air pollution prevention from hospitals during their antenatal care visits was the highest in rural areas. Moreover, their level of satisfaction with counseling had been rated as “satisfied”. Pregnant women often seek information on air pollution prevention from non-professional sources, such as their family and friends.
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Introduction@#Within the framework of health sector reform, the development of the organization, the responsibility of doctors and medical professionals, and the improvement of ethics, quality and safety of care and services are top priorities. Customer satisfaction is important for the implementation of this operation based on results and quality. The WHO Recommendation states that health professionals have a key role to play in providing information and advice to citizens and their families on how to prevent, mitigate and address air pollution, and how to inform the general public and decision-makers. ADB, the Ministry of Health, and UNICEF report that information and promotional materials on air pollution prevention are scarce and do not provide advice to clients. Therefore, it is the reason for conducting a survey to determine the level of satisfaction of clients receiving child health care.@*Materials and methods@#The survey data were collected using quantitative and qualitative research methods. In this study, totally 1160 guardians of children aged 0-5 participated from Songinokhairkhan and Bayanzurkh district and Bayankhongor aimag center. The overall satisfaction of health services is calculated using the three dimensions namely: satisfaction with health service, operation and environment of Health Organization. Satisfaction scores were assessed using an even-point scale. These are “Very Dissatisfied-1 point”, “Dissatisfied-2 point”, “Satisfied-3 point”, “Very satisfied-4 point”. The results were calculated after entering the survey data into SPSS-23, creating a database, and performing error control. Research methodology discussed at the meeting of the Academic Council of the National Center for Public Health on December 25, 2019, and the methodology was approved by the Medical Ethics Committee of the MOH (Stagnant №2).@*Results@#84.7 percent of the respondents were parents of children aged 0-5 years. Their average age is 34, most of them have higher education, and 43.0 percent of them have a household income of 500,000-1 million MNT. Guardians of children aged 0-5 years in Bayanzurkh District were “dissatisfied” with the Family Health Center’s dressing room, wardrobe, toilet and parking lot. Guardians of children aged 0-5 years in Songinokhairkhan district were “dissatisfied” in the parking lot and toilet of the health organization. Guardians of children aged 0-5 years in Bayankhongor aimag were satisfied with the services, operation and environment of the health organization. Studies have shown that 76.5 percent of the guardians did not receive air pollution risk training. As for difficulties in preventing air pollution, 31.4 percent of the surveyed population answered that they cannot change their living and working environment to prevent air pollution.@*Conclusion@#It shows the health care organizations need to improve the hospital environment as well as to provide training how to protect children from air pollution risk for guardians.
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Description@#Asymptomatic bacteriuria is defined as the presence of 1x105 or more bacteria per milliliter of urine, although there are no signs of UTI [1]. Asymptomatic bacteriuria is quite common and occurs in 1-5% of healthy women before menopause. The incidence of asymptomatic bacteriuria increases in the elderly (men and women) to 4-19%. Asymptomatic bacteriuria is observed in 0.7% -27% of patients with diabetes mellitus, in 2-10% of pregnant women and in 23-89% of patients with spinal cord injury. Asymptomatic bacteriuria is rarely observed in young men and always requires differential diagnosis with chronic bacterial prostatitis[2]. </br> Among the elderly, those in institutionalized settings such as long-term care facilities and hospitals have a higher prevalence of asymptomatic bacteriuria than those living in the community. Therefore, interest in asymptomatic bacteriuria has shifted from the general population to these groups of individuals. The prevalence varies from 2% to 10% in pregnancy and from 15% to 50% in the elderly in long-term care facilities.[3,4]</br> This study was undertaken to determine the prevalence of people asymptomatic bacteriuria in among hospitalized people.@*Purpose@#Investigate cases of asymptomatic bacteriuria among hospitalized individuals and determine antibiotic susceptibility by type of pathogen detected in urine.@*Materials and methods@#This cross-sectional study in the “I” Hospital of UB city, Mongolia. We conducted into the study 133 patients. After obtaining informed consent, a midstream clean-catch urine sample was collected in the same 24 hour time window and was evaluated for urinalysis using a dipstick test and routine culture. A positive urine culture was defined as a single urine sample with microbal growth of >10<sup>5</sup> colony- forming units of a single organism. We use 5-10% Blood agar, UTI agar, Mackkong agar and Chroma agar for a bacterial growth. Then we did antibiotic susceptibility of the determined pathogen.@*Result@#The average age of the respondents was 55.9±14.6, the youngest was 17 years old and the oldest was 91 years old (CI 95% 53.4-58.5). By age group, 4.5% (n = 6) of people aged 20-30, 21.1% (n = 28) of people aged 31-45, 37.5% (n = 50) of people aged 46-60, and people over 61 years of age 36.8% (n = 49) respectively.Of the respondents, more than 56 or 54.9% (n = 73) were elderly, of which 63.9% (n = 85) were women and 36.1% (n = 48) were men. </br> A total of 36 (27.1%) leukocytes were detected, and 25 (34.2%) more (P-0.05) were detected in people over 56 years of age. The protein detected in 24 (18.0%) people, all over 56 years of age and more defined in men (P-0.01).</br> 80.5% (n = 107) of those surveyed were diagnosed with the pathogens, and 54.9% were elderly (P-0.031). 82.4% of women and 77.1% of men were diagnosed with urinary pathogens. </br> Streptococcus 26%, E.coli 19%, Saprophyticus 13%, Enterococcus 11% and Staphylococcus 11% were detected in the analysis, and Streptococcus and E.coli (19%) accounted for a slightly higher rate of infection.</br> A total of 13 types of pathogens were identified, of which 53.4% were susceptible, 21.7% were moderately sensitive, and 24.9% were non-susceptible.@*Discussion@#According to a study conducted by researchers at the University of Taiwan, the prevalence of asymptomatic UTI-s in the general population is 57.8%. E.Coli was also the most common bacterium in the urine [6]. </br> In our study, there are many cases of E. coli. </br> Study in the United States found that the prevalence of asymptomatic bacteriuria among inpatients was 8.5%, all of them women. The most common pathogens in this study are Enterococcus bacteria. This study found that 1 in 10 people admitted to the hospital may have asymptomatic bacteriuria. [1] @*Conclusion@#</br> 1. Asymptomatic bacteriuria in 80.5% of those surveyed 54.9% were detected in people over 56 years of age. </br> 2. Antibiotic susceptibility of the tested pathogens was determined as 53.4% sensitive, 21.7% moderately sensitive and 24.9% insensitive.
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Introduction@#Soum and family health care centers (primary health care centers) provide public health services to reduce the negative effects of air pollution on health. In order to decrease the risk factors due to air pollution, it is crucial for health professionals, who are providing health care services to the public, to have the knowledge, attitude and practice to give an advice for residents on how to protect their health from air pollution. The “Air pollution and child health” report from WHO recommended that responsibility of health professionals must include knowing the latest information on air pollution, doing a research, spreading the knowledge, educating families and community and learning from them as well, proposing solutions, and finding a solution for policy developers and decision makers in other sectors. Therefore, we conducted this survey with purpose to determine the long-term effects of air pollution on population psychology and lifestyle and to evaluate the level of knowledge, attitude, and practice of health professionals on how to protect a health from air pollution.@*Goal@#Evaluate the level of knowledge, attitude, and practice of health professionals on air pollution.@*Material and Methods@#In 2019, this study conducted a cross-sectional design and collected quantitative and qualitative data. 88.4% of (n=532) health professionals from 48 secondary health care centers (SHCC) and 64 family health care centers (FHCC), which are agents that implement UNICEF project, in Bayanzurkh, Songinokhairkhan districts and Bayankhongor aimag were participated in the survey.@*Results@#97.4% of the participants agreed that air pollution has negative effects on human health. 99.5% of participants did not know the Mongolian standard for the acceptable level of air pollutant particulate matter (PM) and 73.1% of all participants did not receive information about air quality index. 82.1% of participants regularly give prevention advice with the purpose of protecting maternal and child health from air. The participants who worked for more than 21 years and who are older than 51 years old were more likely to give advice (p<0.05). As for the reasons for not giving advice about air pollution for protecting the maternal and child health, 29.2% of participants answered the service time is not enough, and 22.9% mentioned the lack of knowledge and information. 30.5% (162) of participants were not satisfied with their skill to give an advice on how to protect maternal and child health from air pollution. 86.8% of participants indicated that they did not receive proper training on air pollution and prevention from air pollution.@*Conclusion@#There is a need to provide training and information on how to protect maternal and child health from air pollution for health professionals.
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Background@#The average of cesarean has increased over the last 30 years in developed as well as in developing countries. During the last decade, cesarean surgery rates increased by 1 to 2 times. As of 2015, there were 80434 mothers gave birth nationwide. In Ulaanbaatar city, 267106 births were recorded, from which 14,327 (30.7%) was born with cesarean section. In 2015, 32.2% of all births born in Ulaanbaatar delivered by cesarean surgery, which is 2.5% higher than the previous year. The rate of cesarean surgery has increased dramatically, however, causes and complications are unclear and these subjects are rarely investigated, thus, we decided to study this important issue.@*Material and methods@#The study was carried out through a retrospective design of descriptive statistics. Using cross-sectional study, we randomly collected data from the history of total of 5125 births recorded in the Urguu Maternity Hospital, in 2015 and 408 were selected. Data was collected by using 48 questions in 5 sections. We used the Statistical Package for the Social Sciences (SPSS) 20 for data processing and estimation of survey findings.@*Results@#From the total of 408 women, who given birth by cesarean delivery, 50.2% done under cesarean surgery for the first time, 33.3% for the second time and 16.5% of them experienced with cesarean surgery 3 or more times. The impact of cesarean section on abortions was studied by comparing the rates of cesarean section compared to rates of abortion and we had revealed that 25.3% of cesarean surgery had an abortion once and 11.2% of them twice and 7.4% had 3 or more abortions.@*Conclusion@#Number of chances getting pregnant is age-related (p=0.001). Cases of first cesarean delivery have increased to 50.2%. The frequency of cesarean section and the number of pregnancies was statistically significant (p=0.001). According to the retrospective study of maternity history, 43.9% had abortions. There is an inverse correlation between the rates of cesarean section and rates of abortion (p=0.004). Combination of disorders of the organ systems do not affect the rate of the cesarean section (p= 0.941). Vaginal inflammation does not affect the frequency of cesarean section (p=0.237).
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Background@#In 2017, incidence of STI accounted for 54.6% of all communicable diseases. Syphilis, gonorrhea and trichomoniasis per 10000 populations are higher than the national average and congenital syphilis has been registered regularly over the past 5 years, which is a major problem today. Thus the study aims to research the knowledge, attitude and practice of sexually transmitted diseases in adults of Dornod Aimag.@*Methods@#The population of Dornod aimag was divided into 4 clusters and one cluster from the aimag center and remaining 3 clusters from soums were selected for the study based on the ratio of population aged between 16-49 years. Random sampling was used to select participants from aimag center and 13 soums and total of 342 people selected for the study.@*Results@#Knowledge of sexually transmitted diseases is insufficient. There is no difference in the level of knowledge of sexually transmitted infections between men and women (p = 0.352). There is a difference in the level of knowledge between age groups and the knowledge level increases with age (p = 0.001). For the question about casual sexual behavior, 21.1% of respondents had casual sex intercourse 2-5 times. Gender differences were seen in attitudes toward casual sex, as 27.8% of male and 14.5% of females had casual sex 2-5 times (p=0.000). 18.1% of respondents used condoms during casual sex, while 13.5% occasionally used condoms, and considering the gender of participants, 24.9% of men and 11.6% of women (p = 0.000) used condom during casual sex.@*Conclusion@#In Dornod aimag, there is a lack of awareness of STI and risk behaviors. Furthermore, they have no intention to protect their health due to lack of positive attitude and commitment to protect their sexual health.
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Background@#Ectopic pregnancy accounts for 1-2 percent of all pregnancies and a certain proportion of maternal death. The incidence of ectopic pregnancies has seen more than 3-fold increase over the last 20 years. In 2004, around 70000 women in the United States were diagnosed with ectopic pregnancy and it is one for every 250 pregnant women<sup>2</sup>. Ectopic pregnancy case in South Korea is 17.3 per 1000 pregnant women<sup>9</sup>. In Ireland, the prevalence of the ectopic pregnancy increased from 12.8 per 1000 births in 2005 to 17.1 per 1,000 births in 2016<sup>8</sup>. According to the MCHR study in Mongolia, 2.4% of total pregnant women was reported in maternal death. In Ulaanbaatar, 1.3% of the inpatient women were treated due to ectopic pregnancy and 33.7% of gynecologic surgical patients were women with ectopic pregnancy. In 2005, 171 women were hospitalized for ectopic pregnancy and this increased to 647 in 2015<sup>7</sup>. Incidence of ectopic pregnancy is increasing each year, but this type of comprehensive survey is not enough to provide a basis for selecting the subject. The objective of the study is to study the medical history of inpatient admissions with ectopic pregnancy, retrospectively.@*Methods@#The present retrospective study was carried out through a retrospective database analysis. We studied each patient’s history; total of 615 cases of ectopic pregnancy hospitalized in the Urguu Maternity Hospital, using 5 sections of questionnaires with of 48 questions, between 1 January 2015 and 1 January 2016. We used the Statistical Package for the Social Sciences (SPSS) 20 for data processing and estimation of survey findings. @*Conclusion@#As a result of this study, the highest rate of ectopic pregnancy is 3.8/100 and the highest incidence of ectopic pregnancy was found among women aged 25-35 years, the youngest patient was 19 and the oldest patient was 49, respectively. A 38.6% of women who diagnosed with ectopic pregnancies had to have abortions, 13% had miscarriage, 42.1% had history of vaginal surgery and 32.6% had history of uterine surgery which is most common causes of ectopic pregnancy.
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Introduction@#An international study coordinated by the International Agency for Research on Cancer (IARC) and published today in The Lancet Oncology shows that in 2001–2010, childhood cancer was 13% more common than in the 1980s, reaching an annual incidence rate of 140 per million children aged 0–14 years worldwide. Cancer incidence and mortality statistics reported by International Cancer Research Center (2016), over 300,000 children develop cancer worldwide each year, 215000 children aged 0-14 years and 85000 children aged 15-19 years. Internationally comparable data on childhood cancer incidence in the past two decades are scarce. Based on the need for comparison of childhood cancer incidence in Mongolia to the global level, the study aimed to categorize cancer among children aged 0-19 years. @*Goal@#To study the insidence rates and trend from childhood cancer last 10 year in Mongolia@*Materials and Methods@#The study was conducted in 786 new cases childhood who were cancer diagnosed, between 2008 and 2017 year. Age-standardized incidence rates were calculated by the direct method using age-specific incidence rates and weights based on the age distribution of the standard world population @*Results@#Over the past 10 years, childhood cancer accounted for 1.5% of total cancer in Mongolia. By WHO and IARC data, worldwide childhood cancer age standardized rate (ASR) is 106.0, in Mongolia childhood cancer ASR (101.6) is lower than world average. The most common childhood cancers worldwide are: 1st leukemia, 2nd lymphoma, 3rd central nervous system cancer, 4th retinoblastoma, 5th soft tissue cancer. Over the past 10 years the most common childhood cancers in Mongolia are: 1st leukemia, 2nd central nervous system cancer, 3rd joint bone cancer, 4th lymphoma, 5th soft tissue cancer. Our country’s childhood cancer ASR is below compared to other countries, but expected growth rate is gradually increasing (3.0 per year).@*Conclusions@#</br> 1. Leukemia is the most common childhood cancer in worldwide and also in Mongolia. </br>2. By sex, childhood cancer incidence is higher in boys than girls. </br>3. By age group, childhood cancer incidence is the highest in 0-4 age group. </br>4. By region, childhood cancer incidence is the highest in central region. </br>5. The overall incidence of childhood cancer (1 million children) in Mongolia is expected to increase by 3.0 over the next 5 years.
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GoalTo evaluate the quality, results, and processing of cytology analyses of early detection program ofuterine cervical cancer implemented in Mongolia, which based on Pap test, at Ulaanbaatar city level.Materials and MethodsInformation was collected from the databases of the recalling system of screening program of theCancer registration and information unit of the NCC of Mongolia and districts pathology laboratoreis.Statistical significant level of 1.96 (95% CI) andthe margins of error 0.05 were considered andsample size was calculated by using the information that 10% of unsatisfied results appear onquality assurance of international level. Thus calculations were madefortotal of 1723 (585 positiveand negative 1138) samples, by collecting 287smears from each district.At the district level all the selected slides were reviewed blindly and compared to the previouscytological conclusion. Diagnostic validity was defined by calculating parameters such as specificityand sensitivity, positive and negative predicted values. The Kappa index criteriais used for statisticalcalculation of the cytological diagnosis conclusion matches.ResultsThe target group women coverage of cervical cancer screening program is 40.8%. Out of all positiveresults of early screening cytology, 77% were at an early stage and 23% were at an advanced stage.Thus positive signs were showed with increased detection results in early stage of uterine cervicalcancer (P = 0.05). Positive results of Pap test were follows; ASCUS (53.2%), ASC-H (10.0%), LSIL(19.2%), HSIL (13.4%), CIS (3.4%), and SCC (0, 8%). Out of total slides, 86.7% were as satisfactory.The test results conducted at the district level were90.1% of sensitivity, 88.8% of specificity and9.9% of false negative response. The discrepancy of results of cytology test in districts and repeatedseen is 31.4% (K = 0.749; p = 0.001).ConclusionThe coverage of cervical cancer screening program that has been implementing in our country isnot enough. There are problems at the district level including severe damages of uterine cervix andincomplete diagnosis. The quality of the cytology test is relatively unsatisfied.
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Introduction. Cervical cancer is one of the most common cancers among women worldwide. Its mortality exemplifies health inequity, as its rates are higher in low & middle income countries (LMICs ), and in low socio-economic groups within countries. Around 80% of global cervical cancer cases are in LMICs. (WHO, 2008 ) Goal. To determine the prevalence, incidence and mortality for cervical cancer among Mongolian population Objectives: 1. To determine the trends of incidence and mortality for cervical cancer by regions among Mongolian population during 2000-2009 2. To estimate DALYs for cervical cancer in 2009 Materials and Methods: Data for this study were abstracted from Annual Reports of the National Cancer Registry for 2000-2009.I ncidence and mortality rates were calculated as mean annual numbers per 100,000 residents. Age-standardized incidence rates (ASRs) and age-standardized mortality rates (ASMRs) were calculated by the direct method by weighting age-specific incidence and mortality rates to the World Population. The DALY combines in one measure the time lived with disability and the time lost due to premature mortality: DALY = YLL + YLD YLL – years of life lost due to premature mortality YLD – years lived with disability. Results: last ten years, the trends have been increasing of the prevalence, incidence and mortality rate for cervical cancer in Mongolia. The cervical cancer incidence rates are the highest in Central and Eastern regions than other regions. The average burden of cervical cancer across all regions in 2009 was 2868 DALYs per 100000 population, of which about 30,9% was due to premature death and 69% non-fatal health outcomes. Conclusion: The incidence of cervical cancer is generally low in China, moderate in Japan and somewhat higher in Korea and Mongolia [11]. Need to estimate the DALYs for common cancers in Mongolia.