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    Comparison of Clinical Features of Hepatitis B and C Virus-Related Hepatocellular Carcinoma
    (Mongolian National University of Medical Sciences, 2022-09-30) ;
    Erdenebileg Taivanbaatar
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    ; ;
    Objective: To compare the clinical characteristics of hepatitis B virus-related hepatocellular carcinoma (HBV group) and C virus-related hepatocellular carcinoma (HCV group). Methods: By a single century, we analyzed the clinical characteristics of 23 patients with hepatitis B virus-related hepatocellular carcinoma (HBV group) and 34 with hepatitis C virus-related hepatocellular carcinoma (HCV group). Results: The patients in the HBV group (mean age 61.1 year) were about 6 years younger than those in the HCV group (mean age 67.1 year). Liver function, as measured by indocyanine green retention at 15 min, was better in the HBV group (17.5 %) than in the HCV group (25.4 %). A higher proportion of the HBV group (55 %) than the HCV group (44 %) had clinical stage I. T-factor differed significantly between the groups: 53 % of the HBV group were T3 - 4 compared with 41 % of the HCV group. Furthermore, a higher proportion of the HBV group was graded 2 - 3 for tumor thrombus in the portal vein (20.3 %) and had poorly differentiated hepatocellular carcinoma (7 %) compared with the HCV group (7.1 % and 5 % respectively). Univariate analysis identified poor prognostic factors for hepatocellular carcinoma as HBV, age < or = 50 year, clinical stage II-III, a high AFP level, higher number of tumors, larger tumor size, tumor thrombus in the portal vein 2 - 3 and in the hepatic vein 2 - 3. On multivariate analysis, poor prognostic factors were a high AFP level, a higher number of tumors, and tumor thrombus in the portal vein 2 - 3 and in the hepatic vein 2 - 3, but not HBV, age, clinical stage, or tumor size. In the multiple logistic regression models on the hepatitis infection, the OR for ASAT was 2.01 (95 % CI 1.41 - 6.91), statistically significant (p < 0.05). Conclusion: These results suggest that HBV itself is not a stronger prognostic factor than HCV.
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    An Exploration of Productivity Costs and Years of Potential Life Lost: Understanding the Impact of Premature Mortality From Injury in Mongolia
    This study estimates the years of potential life lost (YPLL), years of potential productive life lost (YPPLL), and cost of productivity loss (CPL) owing to injury-related mortalities in Mongolia. By implementing a retrospective cohort study, the study used secondary mortality data for Mongolia from 2016 to 2020 from the Health Development Center. Our study incorporates information on 13 551 fatalities from injuries and external factors, with the aim of estimating YPLL, YPPLL, and CPL associated with the leading causes injury-induced deaths. These include exposure to toxic substances, road accidents, homicides, suicides, and falls. Our findings reveal majority of the losses occur because of exposure to poisonous chemicals, road accidents, suicides, falls, and homicides. Furthermore, 444 550 years of potential life are lost owing to injury-related mortalities, in which YPPLL accounts for 338 482 years. The CPL caused by these premature deaths during the study period accounts for $1.368 billion. Notably, YPLL, YPPLL, and CPL rates are significantly higher in males than in females. The YPLL from exposure to poisonous chemicals is higher than those caused by other factors. This study is the first to calculate the CPL owing to YPLL from injury in Mongolia.
    Scopus© Citations 4
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    A decade of liver transplantation in Mongolia: Economic insights and cost analysis
    (Springer Science and Business Media LLC, 2024-07) ; ; ; ;
    Ganbold, Urnultsaikhan
    BACKGROUND: Mongolia introduced liver transplantation 10 years ago, becoming the 46th country globally to successfully perform this procedure. However, the cost of liver transplantation treatment remains expensive in Mongolia, a lower-middle-income country. Thus, the need to calculate the cost of liver transplants, a highly-valued treatment, forms the basis for this study. METHODS: This study employed a retrospective research design with secondary data. The primary dataset comprised 143 cases of liver transplantation performed at the First Central Hospital of Mongolia between 2011 and 2021. RESULTS: The average cost of a liver transplant in Mongolia is $39,589 ± 10,308, with 79.6% being direct costs and 20.4% indirect costs. Of the direct costs, 71% were attributed to drugs, medical equipment, and supplies, while 8.6% accounted for salaries. In terms of the Model of End-Stage Liver Disease (MELD) scores, treatment costs were $39,205 ± 10,786 for patients with MELD ≤ 14 points, $40,296 ± 1,517 for patients with MELD 15-20 points, $39,352 ± 8,718 for patients with MELD 21-27 points, and $39,812 ± 9,954 for patients with MELD ≤ 28 points, with no statistically significant difference (P = 0.953). However, when calculated according to the Child-Turcotte-Pugh (CTP) score classification, treatment cost for CTP-A patients was $35,970 ± 6,879, for CTP-B patients $41,951 ± 12,195, and for CTP-C patients $37,396 ± 6,701, which was statistically significant (Р=0.015). CONCLUSION: The average cost of liver transplantation treatment in Mongolia was $39,589. Despite medical facilities' capacity to treat up to 50 patients annually, the waiting list exceeds 300 individuals, highlighting significant unmet healthcare needs.
    Scopus© Citations 2
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    Prevalence and risk factors of Hepatitis E virus infection among Bactrian camel herders in Bayankhongor province, Mongolia
    (Veterinary World, 2024-07)
    Batmagnai, Enkhbaatar
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    Chimedregzen, Bat-Erdene
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    Osorjin, Buyankhuu
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    Bazartseren, Boldbaatar
    Scopus© Citations 3
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    Anthropometric and Body Circumference Determinants for Hand Grip Strength: A Population-Based Mon-Timeline Study
    BACKGROUND: Hand grip strength (HGS) is a tool for diagnosing sarcopenia. In this study, we examined some anthropometric and body circumference measurements as determinants for HGS. METHODS: This cross-sectional study was conducted with participants (Mongolians, n = 1080, aged 18-70, mean age of 41.2 ± 13.9 years, 33.7% of men) from the "Mon-Timeline" cohort study. To measure HGS, a digital grip strength dynamometer was used. RESULTS: Mean HGS in men was 40.1 ± 10.4 kg and in women was 24.5 ± 5.6 kg. Correlation analysis showed that the strongest correlation with HGS was height (r = 0.712, p < 0.001). Moreover, HGS was inversely correlated with age (r = -0.239, p < 0.001) and thigh circumference (r = -0.070, p < 0.01), while it was positively correlated with body weight (r = 0.309, p < 0.001), neck circumference (r = 0.427, p < 0.001), upper arm circumference (r = 0.108, p < 0.0001), lower arm circumference (r = 0.413, p < 0.0001), and calf circumference (r = 0.117, p < 0.0001). In the multivariate linear regression analysis (unstandardized B coefficient, 95% CI), age (-0.159, -0.188; -0.129), sex (-9.262, -10.459; -8.064), height (0.417, 0.357; 0.478), lower arm circumference (1.003, 0.736; 1.270), and calf circumference (-0.162, -0.309; -0.015) were significantly associated with HGS. CONCLUSIONS: When detecting sarcopenia using HGS, it is important to take into account variables such as body height and body circumference.
    Scopus© Citations 11
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    Diseases-attributable disability-adjusted life years in copper and molybdenum ore workers in Mongolia: 1999-2019
    Most illnesses and deaths in industry workers are associated with occupational diseases (ODs). In recent years, mining has grown rapidly into a major driver of the Mongolian economy. In this study, the organization-based registry data on OD incidence and mortality from the archival data of the 'Erdenet' Copper and Molybdenum Concentrator Plant in Mongolia were used. We estimated the ODs burden in disability-adjusted life years (DALYs) loss between 1999 and 2019. A total of 72,802 DALYs were lost over 20 years, of which 97.5% were due to years lived with disability and 2.5% for years of life lost. The disease burden was high in men, accounting for 76.8% of total DALY. In terms of age groups, among people aged 46-55, DALY accounted for the largest percentage of losses. We found that workplace dust, noise, ergonomics, and vibration were the main factors attributed to the DALYs during the past two decades.
    Scopus© Citations 2
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    Occupational Diseases in Mongolia: A Retrospective Analysis (1975-2023) with a 30-Year Trend Study
    (Korean Society of Occupational & Environmental Medicine, 2026-04) ; ; ;
    Ragchaabazar, Ulzii-Orshikh
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    BACKGROUND: Occupational diseases represent a significant global public health challenge, yet reliable data from transitioning economies remain limited. This study aimed to analyze newly confirmed occupational disease cases in Mongolia over a 50-year period (1975-2023), identifying long-term trends and the prevalence of leading disease categories. METHODS: A retrospective, record-based study was conducted using quantitative data from 10,233 officially confirmed and compensated cases of occupational diseases resulting in an officially certified loss of labor capacity. Incidence rates per 100,000 workers were calculated for the 1992-2023 period. Leading diseases were classified by organ system, with focused analyses on respiratory diseases, occupational poisonings, and neurological disorders. RESULTS: Dust- and particulate-induced respiratory diseases accounted for the largest proportion of cases (57.4%), followed by occupational neurological disorders (16.2%) and occupational poisonings (8.0%). From 1992 to 2023, incidence rates among male workers were consistently 3-7 times higher than those among female workers. Analysis of exposure duration showed mean durations of 13.6 ± 4.9 years for silicosis (J62) and 20.7 ± 10.7 years for inorganic substance poisoning (T57). While respiratory diseases were predominant historically, occupational neurological diseases demonstrated an increasing trend after 2015. CONCLUSIONS: Occupational neurological disorders are showing an increasing trend in Mongolia, reflecting a shift in the national occupational disease pattern. However, as the registry is based on the national compensation framework, these findings likely reflect recognized cases rather than the true epidemiological incidence, suggesting potential underreporting. Strengthening surveillance beyond the compensation system and improving diagnostic capacity for a broader range of work-related conditions are essential for effective prevention and policy development.
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    Sex-adjusted approach to baseline variables demonstrated some improved predictive capabilities for disease severity and survival in patients with Coronavirus Disease 19
    (Elsevier BV, 2022) ; ; ;
    Dambaa, Naranzul
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    Boldoo, Tsolmon
    INTRODUCTION: The study was focused on comparing crude and sex-adjusted hazard ratio calculated by the baseline variables which may have contributed to the severity of the disease course and fatal outcomes in Coronavirus Disease-19 (COVID-19) patients. METHOD: The study enrolled 150 eligible adult patients with confirmed SARS-CoV-2 infection. There were 61 (40.7%) male patients, and 89 (59.3%) female patients. Baseline information of patients was collected from patient medical records and surveys that the patients had completed on admission to the hospital. RESULTS: Considerable number of baseline variables stratified according to disease severity and outcomes showed different optimal cut-points (OCP) in men and women. Sex-adjusted baseline data categories such as age; BMI; systolic and diastolic blood pressure; peripheral RBC and platelet counts; haematocrit; percentage of neutrophils, lymphocytes, monocytes, and their ratio; percentage of eosinophils; titre of plasma IL-6, IL-8, IL-10, and IL-17; and CXCL10; and ratio of pro- and anti-inflammatory cytokines demonstrated significant impacts on the development of the severe stage and fatal outcomes by the mean hazard ratio in the Kaplan-Meier and Cox regression models. CONCLUSION: This study confirmed some improved predictive capabilities of the sex-adjusted approach in the analysis of the baseline predictive variables for severity and outcome of the COVID-19.
    Scopus© Citations 1
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    SARS-CoV-2 seroprevalence in Mongolia: Results from a national population survey
    (Elsevier BV, 2021-12) ; ;
    Le, Linh-Vi
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    ;
    BACKGROUND: With the global spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in early 2020, Mongolia implemented rapid emergency measures and did not report local transmission until November 2020. We conducted a national seroprevalence survey to monitor the burden of SARS-CoV-2 in Mongolia in the months surrounding the first local transmission. METHODS: During October-December 2020, participants were randomly selected using age stratification and invited for interviews and blood samples at local primary health centres. We screened for total SARS-CoV-2 antibodies, followed by two-step quantitative SARS-CoV-2 IgG serology tests for positive samples. Weighted and test-adjusted seroprevalences were estimated. We used chi-square, Fisher's exact and other tests to identify variables associated with seropositivity. FINDINGS: A total of 5000 subjects were enrolled. We detected SARS-CoV-2 IgG antibodies in 72 samples. Crude seroprevalence of SARS-CoV-2 antibodies was 1·44% (95%CI,1·21-1·67). Population weighted and test-adjusted seroprevalences were 1·36% (95%CI,1·11-1·63) and 1·45% (95%CI,1·11-1·63), respectively. Age, sex, geographical, and occupational factors were not associated with seropositivity (p>0·05). Symptoms and signs within past 3 months and seropositivity were not associated at the time of the survey (p>0·05). INTERPRETATION: SARS-CoV-2 seroprevalence in Mongolia was low in the first year of the pandemic potentially due to strong public health measures, including border restrictions, educational facilities closure, earlier adoption of mask-wearing and others. Our findings suggest large-scale community transmission could not have occurred up to November 2020 in Mongolia. Additional serosurveys are needed to monitor the local pandemic dynamic and estimate how far from herd immunity Mongolia will be following-up with vaccination programme in 2021 and 2022. FUNDING: World Health Organisation, WHO UNITY Studies initiative, with funding by the COVID-19 Solidarity Response Fund and the German Federal Ministry of Health (BMG) COVID-19 Research and development. TRANSLATION: Cyrillic and Traditional Mongolian translation of abstract is available on appendix section.
    Scopus© Citations 14
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    The Relationship Between Health Parameters, Body Size, Elements of Lifestyle, and Hand Grip Strength in a Group of Patients with Type 2 Diabetes, Aged 40-98, from Ulaanbaatar, Mongolia
    Background/Objectives: Decreased muscle strength and lower hand grip strength (HGS) values are observed in patients with type 2 diabetes (T2D). This study aimed to present the values of hand grip strength as a valuable tool in T2D treatment monitoring in the context of body size and lifestyle elements in 347 patients with type 2 diabetes from Ulaanbaatar, Mongolia. Methods: A retrospective cross-sectional study was performed at hospitals in Ulaanbaatar, Mongolia. The maximum grip strengths of the right and left hands were measured three times, alternatively, using a digital hand dynamometer. The maximum grip strength of the dominant hand was used for the analysis. Results: The values of HGS in both hands dropped with increased age, systolic blood pressure (SBP), the duration of diabetes, and low glucose blood levels, whereas they increased with height. Patients who smoked had the lowest three values of HGS (the average value for each hand), whereas patients who quit smoking had the highest values. Second-order interactions between diastolic blood pressure (DBP) and sex showed a significant effect on the average HGS of both hands and for the left hand in particular (where HGS decreased only in females, whereas it increased in males). Conclusions: HGS is influenced by important socioeconomic and anthropometric factors in patients with type 2 diabetes, making it a valuable indicator of general health.
    Scopus© Citations 1