Hepatitis B, C, and D Virus Infection among Population Aged 10-64 Years in Mongolia: Baseline Survey Data of a Nationwide Cancer Cohort Study.

Hepatitis B, C, and D virus infections are a major public health problem, and Mongolia has one of the highest prevalences of dual and triple infections in the world. We aimed to determine the seroprevalence of hepatitis infection and dual or triple hepatitis infections among 10-64-year-olds. A questionnaire was used to identify risk factors for hepatitis infection, and seromarkers were measured by the fully automated immunologic analyzer HISCL-5000. Among a total of 10,040 participants, 8.1% of the population aged 10-64 was infected with HBV, 9.4% with HCV, and 0.4% with HBV and HCV, and the prevalence of the disease varied by age, sex, and the area of residence. Young people were particularly unaware of their hepatitis infection status. A small proportion of children aged 10 to 19 years and the majority of adults younger than 30 years were unaware of their HBV and HCV infection. Men were also more likely to be unaware of their HBV and HCV infection status than women. The results suggested that the prevalence of infection in the general population is high and that most people are unaware that they are infected or have become chronic carriers. Identifying mono-, co-, or triple-infection status is critical to prevent the rapid progression of liver disease among the Mongolian population.

Hepatitis B, C, and D Virus Infections and AFP Tumor Marker Prevalence Among the Elderly Population in Mongolia: A Nationwide Survey.

OBJECTIVES: Infections with hepatitis B, C, and D virus (HBV, HCV, and HDV) are a major public health problem and lead to serious complications such as cirrhosis and hepatocellular carcinoma. We aimed to determine the seroprevalence of hepatitis B surface antigen (HBsAg), anti-HCV, anti-HDV immunoglobulin G, alpha-fetoprotein (AFP), and dual and triple hepatitis virus infections in Mongolia. METHODS: A total of 2313 participants from urban and rural regions were randomly recruited for this cross-sectional study. A questionnaire was used to identify the risk factors for hepatitis virus infections, and the seromarkers were measured using immunoassay kits. RESULTS: Among all participants, the prevalence of HBV, HCV, and HDV was 15.6%, 36.6%, and 14.3%, respectively. The infection rates were significantly higher in females and participants with a lower education level, rural residence, older age, and a history of blood transfusion. HBV and HCV co-infection was found in 120 (5.2%) participants and HBV, HCV, and HDV triple infection was detected in 67 (2.9%) participants. The prevalence of elevated AFP was 2.7%, 5.5%, and 2.6% higher in participants who were seropositive for HBsAg (p=0.01), anti-HCV (p<0.001), and anti-HDV (p=0.022), respectively. Elevated AFP was more prevalent in participants co-infected with HBV and HCV (5.8%, p=0.023), HBV and HDV (6.0%, p<0.001), and triple-infected with HBV, HCV, and HDV (7.5%) than in uninfected individuals. CONCLUSIONS: Nearly half (49.8%) of the study population aged ≥40 years were infected with HBV, HCV, or HDV, and 22.4% had dual or triple infections.

Prevalence and risk factors associated with human cystic echinococcosis in rural areas, Mongolia.

Cystic echinococcosis is a chronic, complex and neglected zoonotic disease with considerable socio-economic impact on the affected population. Even though Mongolia is included in the list of high cystic echinococcosis risk countries, there has been very limited research and evidence on the prevalence or prevention of cystic echinococcosis. This field-based cross-sectional study to investigate the prevalence of cystic echinococcosis and its potential risk factors in Mongolia was conducted from April 2016 to March 2018. A total of 1,993 people were examined by ultrasound in five provinces of Mongolia. All cystic echinococcosis positive cases were classified according to the WHO-IWGE expert recommendations. The logistic regression model was used to detect the association between the presence of echinococcus infection and each potential risk factor. This was the first community survey based on ultrasound screening in Mongolia. We found 98 cystic echinococcosis cases (prevalence = 4.9%), including 85 abdominal ultrasound cystic echinococcosis positive cases and 13 abdominal ultrasound cystic echinococcosis negative cases (surgically treated cystic echinococcosis cases 11, and 2 confirmed cases of lung cystic echinococcosis by chestcomputed tomography in hospital of Ulaanbaatar). The prevalence of cystic echinococcosis varied greatly among different provinces, ranging from 2.0% to 13.1%. Children, elderly people and those with lower education had higher chances of getting cystic echinococcosis. Rather than dog ownership itself, daily practice for cleaning dog feces was associated with increased odds of cystic echinococcosis. The results of the present study show very high endemicity of cystic echinococcosis in Umnugovi province. Evaluation of potential risk factors associated with cystic echinococcosisshow high significance for following factors: demographics (age), social condition (education level) and hygiene practices (cleaning dog feces and use of gloves). Children under 18 and elderly people are considered as the most risk age groups in Mongolia.

Epidemiologic features of Kawasaki disease in Japan: results of the 2009-2010 nationwide survey.

BACKGROUND: Although the number of patients and incidence rate of Kawasaki disease (KD) are increasing in Japan, the most recent epidemiologic features of KD are not known. METHODS: The 21st nationwide survey of KD was conducted in 2011 and included patients treated for the disease in 2009 and 2010. Hospitals specializing in pediatrics, and hospitals with a total of 100 or more beds and a pediatric department, were asked to report all patients with KD during the 2 survey years. RESULTS: A total of 1445 departments and hospitals reported 23,730 KD patients (10,975 in 2009 and 12,755 in 2010): 13,515 boys and 10 215 girls. The annual incidence rates were 206.2 and 239.6 per 100,000 children aged 0 to 4 years in 2009 and 2010, respectively; the 2010 rate was the highest ever reported in Japan. Monthly number of patients peaked during winter to spring months; lower peaks were noted during summer months. However, the seasonal patterns in 2009 and 2010 differed from those of previous years. The age-specific incidence rate had a monomodal distribution, with a peak during the latter half of the year of birth. The prevalences of cardiac lesions during acute KD and cardiac sequelae were higher among infants and older age groups. Despite a decrease in prevalence, the proportion of patients with giant coronary aneurysms-the most severe sequela of KD-did not substantially decrease. CONCLUSIONS: The incidence rate and number of patients with KD continue to increase in Japan.