Naranzul, Nyamsuren

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Naranzul, Nyamsuren

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Naranzul Nyamsuren

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Naranzul Nyamsuren

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Анагаахын Шинжлэх Ухааны Үндэсний Их Сургууль

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Knowledge, Attitudes, and Practices (KAP) Regarding Hepatitis B Vaccination among Healthcare Workers in Mongolia
(Scientific Research Publishing, 2023-01-01)
Nyamsuren Naranzul
;
Burmaajav Badrakh
;
Altangerel Enkhjargal
;
Byambaa Tumurbat
;
Badamjav Amgalan
Background: Mongolia is no exception and experiencing the burden of HBV among the population. In the last decade, the prevalence of HBV among the relatively healthy population of Mongolia has ranged between 11.8 percent and 10.6 percent, and acute cases are between 1.7 and 1.1 per 10,000 people. We aimed to determine healthcare workers (HCWs) knowledge, attitude, and practices regarding HBV prevention compared to vaccination coverage. Methods: This cross-sectional study was conducted among HCWs from the selected sites through multi-stage sampling. The study involved 1135 HCWs, including medical doctors, nurses, clinicians in both surgical and medical specialties, laboratory technicians, and other staff working in all departments from primary and referral levels in 36 healthcare facilities in two urban and four rural provinces of Mongolia. Participants who consented to the study completed a standardized self-administered questionnaire between July and Dec 2019. Results: Most participants (82.0%) were born before 1992 or before starting a birth vaccination against HBV in Mongolia. The mean age of the participants was 38 years and the participants’ median employment year in the health sector was seven years. Most participants were medical doctors (29.1%) and nurses (28.0%). Five questions explored HCWs’ knowledge about hepatitis B virus infection and prevention, and the correct response ranged between 15.6% and 95.4%. 2.8% of the respondents answered five questions correctly. Men, those with higher levels of education, those over the age of 30, soum family health center HCWs, and doctors and senior medical professionals answered many questions correctly, which is statistically significant. 98.9% of respondents believe that HCWs should vaccinate against HBV. The younger the age (%), management professionals, and service staff are confident in vaccines. A significant difference between age groups, perception of HBV infection, and formal attendance to the official training positively relate to vaccination coverage. Specially survey respondents who knew about the adverse effects of overdosing, learning about total doses of the vaccine, and the effectiveness of the hepatitis B vaccine were more tent to have full doses of the HBV vaccine. Knowledge and working conditions are increasing factors in receiving full doses of the HVB vaccine. Conclusion: The overall knowledge of HBV and its vaccination is fair among the HCWs; however, there is a need to intensify the training on some of the details and increase the training frequency at the workplace. Attitude and practice on infection protection and vaccination are still essential to be promoted among the HCWs. The low level of vaccination coverage is relevant to the level of KAP among the HCWs of the country.
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Efficacy and safety of ledipasvir/sofosbuvir in 5,028 Mongolian patients infected with genotype 1 hepatitis C virus: A multicenter study
(The Korean Association for the Study of the Liver, 2021-01)
Baatarkhuu, Oidov
;
Lee, Jae Seung
;
Amarsanaa, Jazag
;
Kim, Do Young
;
Ahn, Sang Hoon
BACKGROUND/AIMS: Ledipasvir/sofosbuvir (LDV/SOF) shows high efficacy and safety in patients with genotype 1-hepatitis C virus (HCV). We aimed to investigate the efficacy and safety of LDV/SOF in real-world Mongolian patients. METHODS: Between 2015 to 2019, 23 (0.5%) and 5,005 patients (99.5%) with genotype 1a and 1b HCV, respectively, were treated with a fixed-dose tablet containing 90 mg ledipasvir and 400 mg sofosbuvir for 12 weeks, and 81 patients (1.6%) with previous experience of interferon (IFN)-based treatment received additional 1,000 mg ribavirin. HCV RNA was measured at 4, 12, and 24 weeks after the first dose to determine rapid virologic response, end of treatment response (ETR), and sustained virologic response at 12 weeks after end of treatment (SVR12). RESULTS: Most patients (n=5,008; 99.6%) achieved ETR and SVR12 without virologic relapse. Patients with genotype 1a showed low rates of ETR and SVR12 in only 16 patients (69.6%). There was no significant difference in SVR12 rate between patients regardless of IFN experience (n=81; 1.6%), cirrhosis (n=1,151; 22.9%), HCV RNA >6×106 IU/mL (n=866; 17.2%), or liver stiffness >9.6 kPa (n=1,721; 34.2%) (100.0%, 99.3%, 99.4%, and 99.4%, respectively). No severe adverse events (AEs) were reported, and there was no dose reduction or interruption due to AE. The most common AEs were headache (n=472; 9.4%), fatigue (n=306; 6.2%), abdominal discomfort (n=295; 5.9%), and skin rash (n=141; 2.8%). CONCLUSION: LDV/SOF showed high efficacy and safety for patients with genotype 1, especially 1b HCV, in Mongolia. The real-world data might be applicable to patients in other Asian-Pacific countries.
Scopus© Citations 5
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Resistance-associated substitution and ledipasvir/sofosbuvir therapy in Mongolian chronic hepatitis C patients
(Elsevier BV, 2020-03)
Hsu, Shih-Jer
;
Enkhzaya, Sukhee
;
Lin, You-Yu
;
Tseng, Tai-Chung
;
Khosbayar, Tulgaa
BACKGROUND: Mongolia has the highest prevalence of hepatitis C virus (HCV) infection worldwide. Ledipasvir/sofosbuvir (LDV/SOF) was introduced to Mongolia since 2016 for HCV eradication. It has been reported that HCV resistance-associated substitutions (RASs) would affect the effectiveness of LDV/SOF in western chronic hepatitis C (CHC) patients. We thus investigated the effectiveness of LDV/SOF and the impact of RAS on the treatment outcome in Mongolian CHC patients. METHODS: Patients with genotype (GT) 1b HCV infection were prospectively enrolled in Mongolia and treated with LDV/SOF for 12 weeks. The proportion of pre-treatment NS5A Y93H RAS in viral quasispecies was measured with next-generation sequencing. The endpoint of LDV/SOF effectiveness was sustained virological response at post-treatment week 12 (SVR12). RESULTS: A total of 94 CHC patients were evaluated. The baseline Y93H proportion was <1% in 74 patients, 1-15% in 7, 15-50% in 2, and ≥50% in 11. All patients completed 12-week LDV/SOF treatment and the SVR rate was 90.4%. The rate of failure to achieve SVR12 for patients with Y93H < 1%, 1-15%, and ≥15% were 0%, 14.3%, and 61.5%, respectively (p for trend = 0.001). In univariable analysis, older age, baseline alanine transaminase level <40 U/mL, and a higher proportion of Y93H were associated with treatment failure. In multivariable analysis, only a higher proportion of Y93H was associated with treatment failure (p = 0.022). CONCLUSION: LDV/SOF therapy achieves a high SVR rate in Mongolian CHC GT1b patients without baseline Y93H RAS. A higher proportion of Y93H may severely undermine the effectiveness of LDV/SOF.
Scopus© Citations 5
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Hepatitis C Virus Infection in Mongolia: Updated Provincial Data on Prevalence, Genotype Distribution, and Age-Specific Risk Factors
(MDPI AG, 2025-12)
Byambasuren, Amgalan
;
Baatarzorigt, Myagmarjaltsan
;
Otgon, Munkhtuya
;
Bat-Amgalan, Byambasuren
;
Purevkhuu, Mandakhnaran
(1) Background: Mongolia has historically reported one of the highest hepatitis C virus (HCV) prevalence rates globally, with past national estimates exceeding 15%, making HCV infection a major public health priority. This study aimed to assess the prevalence, genotype distribution, and risk factors of HCV infection among residents of Arkhangai Province. (2) Methods: This population-based cross-sectional study was conducted in 2022 including 2304 individuals aged 0-80 years. Serum samples were tested for anti-HCV antibodies using ELISA and for HCV RNA using PCR. Positive samples were genotyped, and demographic and exposure data were analyzed using logistic regression to identify independent risk factors. (3) Results: The prevalence of anti-HCV antibodies was 12.0%, and HCV RNA positivity was 7.16%. Infection increased significantly with age (p < 0.001) and was higher among females (14.6%) than males (8.4%). Genotype 1b predominated (98.2%), followed by 1a (1.2%) and 2 (0.6%). Several exposures showed strong associations with HCV infection in univariate analysis, including cupping therapy (OR 2.37, 95% CI 1.71-3.28), shared razor use (OR 2.39, 95% CI 1.59-3.60), cosmetic procedures (OR 1.70, 95% CI 1.11-2.45), and unsafe injections (OR 2.06, 95% CI 1.40-3.02). In multivariable analysis, four exposures remained independently associated with HCV infection: cupping therapy (adjusted OR 1.89, 95% CI 1.32-2.70), shared razor use (adjusted OR 1.98, 95% CI 1.24-2.89), cosmetic procedures (adjusted OR 1.62, 95% CI 1.39-2.24), and unsafe injections (adjusted OR 1.84, 95% CI 1.19-2.83). (4) Conclusions: HCV infection remains prevalent, particularly among older adults and women. Genotype 1b continues to predominate, indicating that the viral genetic distribution has remained largely unchanged over the past decade. Continued education, safe injection practices, and regulation of traditional and cosmetic procedures are essential to reduce HCV transmission and support Mongolia's elimination goals. These findings highlight the need for comprehensive prevention strategies addressing both unsafe traditional/medical practices and the rapidly expanding cosmetic and aesthetic service sector.

Naranzul, Nyamsuren

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