Obesity, Burden of Ischemic Heart Diseases and Their Ecological Association: The Case of Uzbekistan.

Ischemic heart diseases are the leading cause of death in Uzbekistan. There are numerous risk factors affecting ischemic heart disease, and obesity is one of the major independent risk factors. This study is the first attempt to estimate the ecological association between obesity prevalence and the burden of ischemic heart disease between 1990 and 2019 in Uzbekistan. To define the prevalence of all obesity types, death, and incidences of ischemic heart disease for certain periods, the Joinpoint regression tool was used. A separate linear regression analysis was performed to analyze the relationship between obesity and ischemic heart disease mortality and morbidity. A positive linear relation was found between the prevalence of obesity types and incidence/death rates for both sexes (r = 0.59−0.87). All types of obesity were highly significant positive predictors of incidence of and death from ischemic heart disease (p < 0.0001). The slope (B1) suggested that for an increment in obesity prevalence of 1% among adults aged over 20, the incidence of ischemic heart disease increased by 40.2 (p < 0.0001) and 38.3 (p < 0.0001) per 100,000 persons for men and women, respectively. The current country-level conclusions are valuable, because it allows decision makers to draw specific conclusions, applicable at the state and local level for policymaking.

Factors Associated with COVID-19 Vaccine Hesitancy in Mongolia: A Web-Based Cross-Sectional Survey.

Vaccine acceptance in the general public is essential in controlling the coronavirus disease 2019 (COVID-19) pandemic. The study aimed to assess the COVID-19 vaccine hesitancy in the adult population of Mongolia, and determine the associated factors. A total of 2875 individuals from urban and rural areas were recruited, and completed an online survey. Older age, urban residence, previous vaccination, high education, good knowledge of side effects, and a personal view of the importance of vaccines were associated with vaccine acceptability, whereas gender and religion were not. Receiving COVID-19 vaccine information from official government pages was related to a higher acceptance rate. Reliance on social media as a source of COVID-19 vaccine information was associated with high level of vaccine hesitancy. The side effects and the type of the COVID-19 vaccine were a major reason for hesitation. Countering false information regarding COVID-19 vaccines on social media, and promoting vaccine importance on general news websites is necessary. Moreover, providing clear and direct educational materials through official communication channels on the safety and efficacy of COVID-19 vaccines alongside information on COVID-19 symptoms, vaccine side effects, and location of vaccine administration centers among the younger populations, rural residents, and those with lower education is needed.

Disparities in outpatient and inpatient utilization by rural-urban areas among older Mongolians based on a modified WHO-SAGE instrument.

BACKGROUND: Mongolia has made significant progress towards achieving Universal Health Coverage (UHC), but there are still challenges ahead with population ageing and non-communicable diseases (NCDs). The purpose of this study was to investigate patterns and determinants of outpatient and inpatient health service use amongst older people in Mongolia. METHODS: Data were collected using a questionnaire developed for the World Health Organization's Study on global AGEing and adult health (WHO SAGE). There were 478 participants from rural areas and 497 participants from Ulaanbaatar (further divided into 255 ger/yurt district and 242 apartment district residents). Multivariable logistic regression analyses were used to investigate determinants of outpatient and inpatient health service use with reported adjusted Odds Ratios (AORs) and 95 % Confidence Intervals (CIs). RESULTS: Participants were aged 60 to 93 years. About 55 % of respondents used outpatient services in the past 12 months and 51 % used inpatient services in the past three years. Hypertension was the most common reason for health service use. Rural residents had longer travel times and were more likely to incur out-of-pocket expenditure (OOP). Multivariable logistic regression revealed that women were more likely to use outpatient services (AOR 1.88; 1.34-2.63). Compared to apartment residents in urban areas, ger residents in urban areas were less likely to use outpatient services (AOR 0.54; 0.36-0.83). There was no statistically significant differences in inpatient service by location. Increasing numbers of chronic conditions (1 and 2+ compared to none) were associated with both outpatient (AORs 2.59 and 2.78) and inpatient (AORs 1.97 and 3.01) service use. CONCLUSIONS: This study highlights the needs to address disparities in outpatient service use for rural and urban ger populations. Compared with other WHO-SAGE countries, older Mongolians have relatively higher use of inpatient health care services. With a high prevalence of hypertension and an ageing population, efforts to achieve UHC would benefit from reorienting care services towards prevention and primary care management of NCDs to reduce the costs from hospital-based care.