Evaluation of air pollution prevention consultation, Ulaanbaatar / Монголын Анагаах Ухаан

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.

BRAIN ABSCESS IN CHILDREN / Мэс засал

Introduction: A brain abscess is a serious disease of the central nerve system. We conducted this study to summarize the clinical manifestations and outcomes of brain abscesses. Materials and Methods: A retrospective chart review of pediatric patients diagnosed with brain abscesses from November 2000 to Jаn 2016 was performed at Shastin Medical Hospital neurosurgery department. Results: Twenty-five patients were included in this study. On average, 1.67 cases per year were identified and the median age was 4.3 years. The common presenting clinical manifestations were fever (18/25, 72%), seizure (12/25, 48%), altered mental status (11/25, 44%), and signs of increased intracranial pressure (9/25, 36%). A total of 14 (56%) patients had underlying illnesses, with congenital heart disease (8/25, 32%) as the most common cause. Predisposing factors were identified in 15 patients (60%). The common predisposing factors were otogenic infection (3/25, 12%) and penetrating head trauma (3/25, 12%). Causative organisms were identified in 64% of patients (16/25). The causative agents were S. intermedius (n=3), S. aureus (n=3), S. pneumoniae (n=1), Group B streptococcus (n=2), E. coli (n=1), P. aeruginosa (n=1), and suspected fungal infection (n=5). Seven patients received medical treatment only while the other 18 patients also required surgical intervention. The overall fatality rate was 16% and 20% of patients had neurologic sequelae. There was no statistical association between outcomes and the factors studied. Conclusion: Although uncommon, a brain abscess is a serious disease. A high level of suspicion is very important for early diagnosis and to prevent serious consequences.

BRAIN ABSCESS IN CHILDREN / Мэс засал

Introduction: A brain abscess is aserious disease of the central nerve system.We conducted this study to summarize theclinical manifestations and outcomes ofbrain abscesses.Materials and Methods: A retrospectivechart review of pediatric patients diagnosedwith brain abscesses from November 2000 toJаn 2016 was performed at Shastin MedicalHospital neurosurgery department.Results: Twenty-five patients wereincluded in this study. On average, 1.67cases per year were identified and themedian age was 4.3 years. The commonpresenting clinical manifestations were fever(18/25, 72%), seizure (12/25, 48%), alteredmental status (11/25, 44%), and signs ofincreased intracranial pressure (9/25, 36%).A total of 14 (56%) patients had underlyingillnesses, with congenital heart disease(8/25, 32%) as the most common cause.Predisposing factors were identified in 15patients (60%). The common predisposingfactors were otogenic infection (3/25, 12%)and penetrating head trauma (3/25, 12%).Causative organisms were identified in 64%of patients (16/25). The causative agentswere S. intermedius (n=3), S. aureus (n=3),S. pneumoniae (n=1), Group B streptococcus(n=2), E. coli (n=1), P. aeruginosa (n=1),and suspected fungal infection (n=5). Sevenpatients received medical treatment onlywhile the other 18 patients also requiredsurgical intervention. The overall fatality ratewas 16% and 20% of patients had neurologicsequelae. There was no statistical associationbetween outcomes and the factors studied.Conclusion: Although uncommon, a brainabscess is a serious disease. A high level ofsuspicion is very important for early diagnosisand to prevent serious consequences.

The study results of correlation between levels of contamination of Kharaa and Orkhon river’s water and rate of gastorintestinal infectious disease of people who live near to Selenge river basin / Шинэ санаа Шинэ нээлт

In recent years, many researches that is related to waterborne diseases, especially diarrhea and water quality, safety, personal sanitation, hygiene have been conducting in developing country. Kharaa and Orkhon river are tributaries of the Selenge river basin and the many industries,agriculture, mining, provinces, soums are located in the near of Selenge river basin. Also Tuul,Kharaa and Orkhon river water is very polluted (Mongolian human Development Report 2010: Water and Development report).The aim of the research is to study correlation between to Kharaa and Orkhon river’s water pollution level and rate of gastrointestinal infectious diseases of people who live in the near of Selenge river basin.We analysed Kharaa and Orkhon river’s water quality and statistical data of gastrointestinal infectious diseases (such as dysentery, diarrhea, hepatitis A virus and others). Then we conducted correlation analysis between to river water pollution level and rate of intestinal infectious diseases. Kharaa and Orkhon river’s water was determined “less polluted” by physical, chemical andorganic indicators. But total number of bacteria was determined highly and Proteus vulgaris,Citrobacter freundi, Enterobacter agglomerans pathogens were detected in these river’s water. There were significant positive correlations between level of nitrit in river water and incidence of dysentery and diarrhea. (r=0.38, p=0.022; r=0.291, p=0.005).

Some results of the study on morbidity of gastrointestinal infectious diseases among population of soums in Selenge River Basin / Монголын Анагаах Ухаан

INTRODUCTION:Waterborne diseases, especially diarrhea, related to water quality and safety, personal sanitation and hygienehave been still reported very high in developing countries. Globally, there are an estimated 1.4 million casesof hepatitis A every year. The hepatitis A virus is transmitted through ingestion of contaminated food and wateror through direct contact with an infectious person. Hepatitis A is associated with a lack of safe water and poorsanitation [2].Dysentery is bloody diarrhea, i.e. any diarrheal episode in which the loose or watery stools contain visiblered blood. Dysentery is most often caused byShigella species (bacillary dysentery) or Entamoeba histolytica(amoebic dysentery) [3].Kharaa and Orkhon River are tributaries of the Selenge River-basin, in which many mining and other industries,agriculture, and residential areas reside. It has become a one pollutant factor for water of the Kharaa andOrkhon rivers. As a result, water of the Tuul, Kharaa and Orkhon River was reported to be highly contaminated(Mongolian Human Development Report 2010: Water and Development report) [4].GOAL:The aim of the research was to study incidence of gastrointestinal infectious diseases among population ofsoums are located in Selenge River Basin.MATERIALS AND METHODS:Data on health statistics 2009-2013 years of gastrointestinal infectious diseases, including dysentery, diarrhea,hepatitis A virus and others, were collected and analyzed.RESULTS:Incidence of dysentery was registered highly among people who live in Mandal soums in 2009-2013 years. Butincidence of dysentery (per 10 000 population 2.82) among population ofMandal soum lower than the Selengeprovince and National average. Incidence of hepatitis A virus was registered highly among people who livein Orkhon (74.46), Orkhontuul (48.86) soums and it was greater than 1.3-2 times than the Selenge provinceaverage. Incidence of diarrhea was registered highly among people who live in Khushaat soum and it wasgreater than 2.18-3.8 times the than Selenge province averageCONCLUSION:Incidences of diarrhea and hepatitis A virus were registered highly in Orkhon, Orkhotuul and Khushaat soumscompared to other target soums and it was greater than 1.3-3.8 times than the Selenge province average.Especially, these diseases were registered highly among 0-16 aged children.

Water quality analysis of Kharaa and Orkhon river / Монголын Анагаах Ухаан

INTRODUCTION:According to the report from 2010, Mongolian water consumption was 550 million cubic meter andapproximately 9.1% of the total Mongolian population obtain their water from inadequate hygiene waterresources - springs and rivers. Due to non-hygiene water usage has caused water-born communicableand non communicable diseases among the population. In the last years there has been issue of pollutionof one of the Mongolia’s more representative river Selenge and its following rivers -Kharaa, Orkhon andit is necessary to evaluate water pollution of these rivers.GOAL:To determine water chemical and biological pollution of Kharaa and Orkhon river and to evaluate waterqualityMaterials and MethodsWe collected water, sediments and macro invertebrates sample from three points of river -upstream,midstream, downstream and for Kharaa river the samples were collected from Tunkhel, Mandal andBayangol soum, fo Orkhon river the sequence was Orkhontuul, Orkhon, Khushaat soum. Samples werecollected June, August, October of 2011, 2013.In water sample, we determined physic-chemical 15 parameters including temperature, pH, total dissolvedsolids, conductivity, smell, color, hardness, sulfate, chloride, nitrate, nitrite, ammonia, dissolved oxygen,biological oxygen demand and mercury using their standard methods. Macro invertebrate samples werecollected to evaluate water quality and we determined mercury in sediments and macroinvertebratesamples to evaluate mercury contamination.RESULT:Physic-chemical results of the water showed that water of Kharaa, Orkhon rivers were classified lowmineralized, soft water and nutrient pollution indicators for ‘slightly polluted’category. For dissolved andbiochemical oxygen, they were belong to the category of ‘pure water’.There were no correlation between 2012 and 2013 results and mercury in water, sediments and macroinvertebrates were qualified standard value.CONCLUSION:According to research results water quality of Kharaa, Orkhon river was good and have less pollution andit is possible to use in household consumption after proper cleaning and disinfection.

Prevalence of arterial hypertension in the gobi population and its correlation with certain risk factors / Монголын Анагаах Ухаан

IntroductionCardiovascular diseases are among the first three causes of mortality in the global population. 1 billion people in the world suffer from arterial hypertension2. In USA 60 million people have high arterial blood pressure, while 40% of the adult population of Russia have arterial hypertension. In Mongolia 28% of the adults suffer this disease. For most countries, arterial hypertension is both health and social problems. Studies of research centers in the USA and Western European countries demonstrate that decreasing the prevalence of arterial hypertension diseases can prolong the life expectancy3. There is an increasing trend of cardiovascular diseases in the Gobi region on Mongolia (10000:645.63 in Umnugobi aimag) with no tendency to decrease predicted in the near future4,5.ResultsWe conducted the study in order to define the intermediate risk factors causing the cardiovascular diseases on the aimag and soum levels. The study involved 754 people over the age of 30 years from 14 soums of 4 aimags. Of these participants, 26.3% are males and 73.7% are females. Our study shows high prevalence of arterial hypertension among the population, particularly among the working age population. A majority of the people over 30 years old taking park in our study had a low level of education, lower than minimum living standard income and unemployed. Among the people aged over 30 years, every fifth person uses tobacco and every seventh abuses alcohol and it shows that there is high index of alcohol and tobacco use among the population. 92.4% of the reviewed used less than 5 units of fruits and 90.8 of them used less than the same units of vegetables.ConclusionThus, the Gobi region population consumes insufficient quantity of fruits and vegetables with the entire food pattern being generally unhealthy. Hypodynamia is common among the population varying across the ages, sexes, occupation groups and locations. The average systolic and diastolic pressures are higher in men than in women. The prevalence of overweight and obesity is high due to lack of physical exercising, weight control and optimization of food intake. As to the genders, women have a higher risk for overweight. Blood cholesterol and triglyceride levels are higher in men. The correlation between arterial hypertension and consumption of alcohol and tobacco, obesity and overweight and hypodynamia is strong.

Isolated systolic hypertension and physical activity / Монголын Анагаах Ухаан

IntroductionIsolated systolic hypertension (ISH) has been found to increase the risk of stroke and coronary heart disease significantly among both middle-aged and elderly men and women. ISH is a higher risk factor for cardiovascular diseases (CVDs) than isolated diastolic hypertension. Because of this it is important to determine the prevalence of ISH and its associated risk factors in order to reduce CVD mortality and morbidity in Mongolia.ObjectivesThe aim of the study was to compare the physical activity of people with ISH to it of people with normal blood pressure (BP).Мaterials and MethodsWe examined the physical activity using the data of “Mongolian STEPS Survey on the Prevalence of Noncommunicable Disease and Injury Risk Factors-2009”. ISH was defined as systolic BP≥140 mmHg and diastolic BP<90 mmHg. The Control (normotensive) group comprised subjects whose systolic BP<140 mmHg and diastolic BP<90 mmHg. Using to approach of WHO “STEPS” Survey, physical activity was assessed on intensity, duration and frequency of physical activity at work, in recreational settings and during transportation using complex set of 16 questions.ResultsAccording to the survey results, 74% of people who had normal BP and 48.7% of people with ISH engaged in moderate levels of physical activity in recreational settings daily a week. It was statistically difference in two groups. Males with ISH were more likely to engage in high levels of physical activity at work and in recreational settings compared to females. In terms of age differences, moderate and high levels of physical activity at work decreased steadily with age. Mean duration and frequency of physical activity a week weren”t difference in two groups.ConclusionFrequency of physical activity decreased with age in respondents with Isolated systolic hypertension. Males engaged more in high levels of physical activity at work and in recreational settings more than females. Moderate levels of physical activity in recreational settings was lower in respondents with ISH compared to respondents who had normal blood pressure (p<0.05).

Arsenic content of drinking water in Mongolia / Монголын Анагаах Ухаан

Background: Population of a significant number of countries in the world use drinking water high in arsenic content. Asia is a leading region in the world by the endemic arsenic prevalence and countries such as India, Bangladesh, China and Taiwan have high prevalence of arsenic. The fact that in neighboring China, namely, in Inner Mongolia, the number of cases of neuropathy and skin cancer has been increasing, amplifies the necessity for such studies. It is essential to conduct further research in order to identify arsenic content in drinking water throughout the country.Goal: The survey aims at studying arsenic content in drinking water and mapping arsenic prevalence by aimags and soumsMaterials and Methods: The survey was conducted nationwide –21 aimags and urban areas, in total, arsenic content in drinking water was studied in 291 soums in 867 wells. Arsenic content was identified with a test kit developed by Mahidol University, Thailand. Results: Out of 867 well water samples from 21 aimags and Ulaanbaatar studied for the survey, 91 or 10.5% contained arsenic. Arsenic was found in well water of all aimags except Bulgan, Zavkhan, Orkhon, Selenge and Huvsgul aimags. Nationwide, average arsenic content in drinking water is 0.014+ 0.003mg/l. Highest arsenic content was found in Dornogobi (53.9%), Dundgobi (31%) and Sukhbaatar (27.3%) aimags. Although average arsenic content in drinking water in selected wells in Tuv, Gobisumber, Dornogobi, Gobi-Altai, Dornod, Sukhbaatar and Dundgobi aimags contains 1.2-5 times more arsenic than UST-900-92 standard and WHO recommended content. Out of all studied samples, water from well #3 in Khatanbulag soum, Dornogobi, contained 0.07mg/l arsenic which is the highest – 0.065mg/l more than UST-900-92 standard and WHO recommended content.Concliusions:1. Out of 867 well water samples 10.3% contained arsenic.2. Arsenic content in drinking water nationwide is 0.014+-0.003mg/l. The highest arsenic content is recorded in Khatanbulag soum, Dornogobi – 0.075mg/l.

Hygienic assessment and arsenic content in drinking water in Gobi provinces / Монголын Анагаах Ухаан

Background: A water supply sufficiency and quality standard has been still important object of the priority issues of countries, regions as well as the Worldwide. In December, 2003, the General Assembly of the UN announced to worldwide a decade named as "Water for life" with duration of 2005 - 2015. Public Health Institute of Mongolia,2 Health Sciences University of Mongolia Background: A water supply sufficiency and quality standard has been still important object of the priority issues of countries, regions as well as the Worldwide. In December, 2003, the General Assembly of the UN announced to worldwide a decade named as "Water for life" with duration of 2005 - 2015. Ensure environmental sustainability objective 6.16 within MDGs of Mongolia proposed to decrease a share of inhabitants without safe drinking water, and a share of inhabitants not provided by an improved sanitation infrastructure, respectively. After Mongolia shifted to a market economy system, production rapidly developed, and rapid increasing of mining, population centralization in urban areas and use of the chemical elements were basic and necessary conditions to study an arsenic content in drinking water of Gobi provinces. Goal: To determine arsenic content in drinking water of Gobi provinces and provide a hygienic assessment. Materials and Methods: Research study designed by cross-section methods and analyzed one action data. In total of 62 soumsfrom five Gobi provinces (namely Gobi-Altai, Gobisumber, Dornogobi, Dundgobi, and Umnugobi) were selected as a research sites. Samples are taken according to the standard MNS ISO 5667-2:2001 from total of 142 deep drilled wells amongst 62 selected soums. According to the ISO-MNS 11885:2007 standard, arsenic content (As) were tested in the samples by using Optical Emission Spectrometer with brand name of Varian 720 -ESICP. Test analyses were assessed after comparison with the content level of arsenic in drinking water standard of Mongolia as coded MNS 900:2005 and the recommended levels stated in "Guidelines for drinking water quality", developed by the WHO. Results: Arsenic contents were presented 106 samples, represented 74.6 percent of the total samples from the 142 deep drilled wells in the selected sites of 62 soums among 5 Gobi provinces. In additionally, existing arsenic contents in 22 samples were 15.4 percent of the selected samples counted 1 to 6 times higher than the drinking water standard of Mongolia as coded MNS 900:2005 and the recommended levels stated in "WHO - Guidelines for drinking water quality". Total drinking water arsenic contents across the selected 5 Gobi provinces were statistical mean 0.0084 ± 0.0009 mg/l. Conclusion: 15.4 percent arsenic contents in drinking water in Gobi provinces were greater than the drinking water standard of Mongolia as coded MNS 900:2005 and the recommended levels stated in "WHO - Guidelines for drinking water quality".