Health-Seeking Behavior among Tuberculosis Suspected Cases in Major Cities of Mongolia

Objective: To assess the health-seeking behavior among presumptive TB cases in a Mongolian population-based TB prevalence survey. Tuberculosis (TB) is a major public health concern in Mongolia. TB prevalence survey provides a chance to explore health seeking behavior at the population level. Methods: A population based, cross-sectional survey was conducted using 51 cluster samplings in Mongolia. Participants were interviewed for TB symptoms and their health seeking behavior aged 15 years and above. Participants with a cough lasting two weeks were classified as TB suspects. Results: Of 27,112 survey participants, 4.6% had cough more than two weeks. Forty-eight percent of them had sought health care and to reported pharmacies (26.2%), family group practitioners (45.7%), district health centers (13.3%), and private physicians (3.6%) as first point of contact. The young adults (46.8%) and students (61.0%) approached pharmacies for care more often than their counterparts. Preference for family clinics increased with age. Conclusions: In this survey, 48.1% of the TB suspects had visited a health-care provider. TB case detection need to be improved by retraining health staffs of family health facilities

An e-registry for household contacts exposed to multidrug resistant TB in Mongolia.

BACKGROUND: The WHO recommends that individuals exposed to persons with multidrug resistant tuberculosis (MDRTB) should be screened for active TB and followed up for 2 years to detect and treat secondary cases early. Resource prioritisation means this is rarely undertaken and where it is performed it's usually using a paper-based record, without collation of data. Electronic data collection into a web-based registry offers the opportunity for simplified and systematic TB contact surveillance with automatic synthesis of data at local, regional and national level. This pilot study was designed to explore the feasibility of usage of a novel e-registry tool and explore obstacles and facilitating factors to implementation. METHODS: In parallel with their paper records, seven dispensaries in Ulaanbaatar, Mongolia collected standardized data electronically using Open Data Kit (ODK). Patients with MDRTB and their contacts were recruited during a single clinic visit. Staff and patients were interviewed to gain insights into acceptability and to identify areas for improvement. RESULTS: Seventy household contacts of 32 MDR-TB index patients were recruited. 7/70 contacts (10%) traced had active TB at the time they were recruited to the e-registry. Paper registry satisfaction was low; 88% of staff preferred the e-registry as it was perceived as faster and more secure. Patients and their contacts were generally supportive of the e-registry; however, a significant minority 10/42 (24%) of index cases who were invited, declined to participate in the e-registry, with data security cited as their top concern. CONCLUSION: E-registries are a promising tool for MDRTB contact tracing, but their acceptability amongst patients should not be taken for granted

Association between household solid fuel use and tuberculosis: cross-sectional data from the Mongolian National Tuberculosis Prevalence Survey

令和4年