Vitamin D, respiratory infections, and chronic disease: Review of meta-analyses and randomized clinical trials.

We examined the knowledge, attitudes, and practices of primary care doctors in Ulaanbaatar, Mongolia using a recently developed World Hypertension League survey. The survey was administered as part of a quality assurance initiative to enhance hypertension control. A total of 577 surveys were distributed and 467 were completed (81% response rate). The respondents had an average age of 35 years and 90.1% were female. Knowledge of hypertension epidemiology was low (13.5% of questions answered correctly); 31% of clinical practice questions had correct answers and confidence in performing specific tasks to improve hypertension control had 63.2% "desirable/correct" answers. Primary care doctors mostly had a positive attitude toward hypertension management (76.5% desirable/correct answers) and highly prioritized hypertension management activities (85.7% desirable/correct answers). Some important highlights included the majority (> 80%) overestimating hypertension awareness, treatment, and control rates; 78.2% used aneroid blood pressure manometers; 15% systematically screened adults for hypertension in their clinics; 21.8% reported 2 or more drugs were required to control hypertension in most people; and 16.1% reported most people could be controlled by lifestyle changes alone. 55% of respondents were not comfortable prescribing more than 1 or 2 antihypertensive drugs in a patient and the percentage of desirable/correct responses to treating various high-risk patients was low. Most (53%-74%) supported task shifting to nonphysician health care providers except for drug prescribing, which only 13.9% supported. A hypertension clinical education program is currently being designed based on the specific needs identified in the survey.

Causes for employee absenteeism vary. The commonest cause of work absenteeism is “illness-related.” Mongolia’s capital city, Ulaanbaatar, experiences high employee absenteeism during the winter than during other seasons due to the combination of extreme cold and extreme air pollution. We identified direct and indirect costs of absenteeism attributed to air pollution among private-sector employees in Ulaanbaatar. Using a purposive sampling design, we obtained questionnaire data for 1,330 employees working for private-sector companies spanning six economic sectors. We conducted 26 employee focus groups and 20 individual employer in-depth interviews. We used both quantitative and qualitative instruments to characterize the direct and indirect costs of absence due to illnesses attributed to severe air pollution during wintertime. Female employees and employees with a young child at home were more likely to be absent. Respiratory diseases accounted for the majority of reported air pollution-related illnesses. All participants perceived that air pollution adversely affected their health. Individual employee direct costs related to absence totaled 875,000 MNT ($307.10) for an average of three instances of three-day illness-related absences during the winter. This sum included diagnostic and doctor visit-related, medication costs and hospitalization costs. Non-healthcare-related direct cost (transportation) per absence was 50,000₮ ($17.60). Individual indirect costs included the value of lost wages for the typical 3-day absence, amounting to 120,000₮ ($42.10). These total costs to employees, therefore, may amount to as much as 10% of annual income. The majority of sick absences were unpaid. Overall, the cost of wintertime absences is substantial and fell disproportionately on female employees with young children.

Objective: To describe the demographics, nature of the injury and visual outcomes of pediatric patients presenting with traumatic cataract requiring surgery at the National Center for Maternal and Child Health in Mongolia and to compare the relevant literature on traumatic pediatric cataracts in other countries. Methods: The charts of individuals aged ≤ 18 years who underwent surgery for traumatic cataract over a two-year period at a pediatric hospital were reviewed. The data collected included: demographic information, mode and time of injury, intraocular lens type, surgeries pre-and post-operative best-corrected visual acuity, and surgical complications. Results: Over the 2-year study period, 27 children underwent cataract surgery for traumatic cataract. The mean age was 8.52 ± 4.7 years (range, 1-17 years). The type of primary insult was penetrating injury in over 80% of patients. The mean interval between injury and cataract surgery was 7 ± 6.5months. Pre-cataract surgery no patient had vision better than 20/40; after cataract surgery 36% had 20/50. Conclusion: A better understanding of the causes of eye injuries and the environments in which they occur can provide informed educated strategies for parents, caregivers, and teachers and can possibly reduce time to treatment.

Objective: To describe the clinical characteristics of pediatric cataracts in children undergoing surgery in our tertiary care center in Mongolia. Methods: Patients aged ≤ 18 years who underwent pediatric cataract surgery over a three-year period at our pediatric hospital in Mongolia were included. The data collected included: demographic information, family history, laterality, morphology, etiology, and coexistent ocular and systemic disease, age at diagnosis. Results: Over the 3-year study period, 118 children underwent surgery for pediatric cataracts. Sixty participants (53.4 %) had congenital and 92 (78 %) had bilateral cataracts. The most common etiology of pediatric cataracts was idiopathic (34 cases, 28.8 %). Lamelar cataracts were the most commonly observed pediatric cataract (23.8 %). Microphthalmos/microcornea was the most frequent ocular malformation seen in pediatric cataracts. Conclusions: The most common etiology of congenital cataracts was idiopathic, whereas developmental cataracts were most commonly hereditary. In almost all patients, the main morphology of congenital cataracts was nuclear, and the main morphology of developmental cataracts was lamellar. In congenital and developmental cataracts, the main associated ocular disorder was microphthalmos/ microcornea. The most common associated systemic disorder in developmental cataracts was Type 1 diabetes and in congenital cataracts was Down syndrome.