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Objectives In recent years Mongolia has made great advances towards Millennium Development Goals to reduce maternal and child mortality, however few studies have investigated maternal and child health status several years after childbirth. Our study aims to describe priority health issues in maternal and child health in Mongolia 3 years after childbirth, and key areas requiring further health policy development. Methods We conducted a population-based cross-sectional study in Bulgan province, Mongolia. Participants were women who gave birth in 2010 and lived in Bulgan in 2013, and their children who were almost 3 years of age. Data was collected using structured interviews, self-administered questionnaires, transcribed records from the Maternal and Child Health Handbook, anthropometric measurements, and a developmental assessment tool. Results Data was obtained from 1,019 women and 1,013 children (recovery rate: 94.1 %). Among women, 171 (17.2 %) were obese and had an average body mass index (BMI) of 25.7, 40 (4.4 %) experienced intimate partner violence (IPV) and 356 (36.2 %) reported urinary incontinence in the past month. Among children, 110 (10.8 %) were assessed as at risk of developmental delay, 131 (13.1 %) were overweight or obese, burns accounted for the highest number of serious accidents at 173 (17.0 %) while lower respiratory tract infections (LRTIs) were the most frequent cause of pediatric hospitalization. Conclusions for Practice Further development in health policy is required in Mongolia to target the significant health challenges of obesity, IPV, and urinary incontinence in women, and obesity, development delay, burns, and LRTIs in children., Author(s): Kenji Takehara[sup.1] , Amarjargal Dagvadorj[sup.1] [sup.2] , Naoko Hikita[sup.3] , Narantuya Sumya[sup.4] [sup.5] , Solongo Ganhuyag[sup.5] , Bayasgalantai Bavuusuren[sup.5] , Erika Ota[sup.1] , Megumi Haruna[sup.3] , Mikako Yoshida[sup.6] , [...]

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Objective To estimate the prevalence and identify the determinants of non-prescription use of antibiotics for children in Mongolia. Methods A community-based cross-sectional survey was undertaken in 10 subdistricts in Ulaanbaatar, Mongolia's capital. We used a structured questionnaire to collect data from a random sample of 540 households with at least one child aged < 5 years. Logistic regression was used to identify factors associated with antibiotic misuse. Findings Of 503 participating caregivers, 71% were mothers; 42.3% (95% confidence interval, CI: 37.8-46.9) of caregivers had used non-prescribed antibiotics to treat symptoms in their child during the previous 6 months. Symptoms commonly treated were cough (84%), fever (66%), nasal discharge (65%) and sore throat (60%). Amoxicillin was the most commonly used antibiotic (58%). Pharmacies were the main source (86%) of non-prescribed antibiotics. Non-prescribed use by mothers was significantly associated with keeping antibiotics at home (odds ratio, OR: 1.7; 95% CI: 1.04-2.79), caregiver self-medication (OR: 6.3; 95% CI: 3.8-10.5) and older child's age (OR: 1.02; 95% CI: 1.01-1.04). Caregivers with a better knowledge of antibiotics were less likely to give children non-prescribed antibiotics (OR: 0.7; 95% CI: 0.6-0.8). Conclusion The prevalence of non-prescribed antibiotic use for young children was high in Ulaanbaatar. Because such use leads to the spread of bacterial resistance to antibiotics and related health problems, our findings have important implications for public education and the enforcement of regulations regarding the sale of antibiotics in Mongolia. Objectif Estimer la prevalence et identifier les determinants de l'utilisation sans prescription d'antibiotiques chez les enfants en Mongolie. Methodes Une etude communautaire transversale a ete menee dans 10 sous-districts d'Oulan Bator, la capitale de la Mongolie. Nous avons utilise un questionnaire structure pour collecter des donnees a partir d'un echantillon aleatoire de 540 menages comptant au moins un enfant age de moins de 5 ans. La regression Iogistique a ete utilisee pour identifier les facteurs associes a l'usage abusif d'antibiotiques. Resultats Sur 503 adultes referents ayant pris part a cette enquete, 71% etaient des meres; 42,3% (intervalle de confiance de 95%, IC: 37,8-46,9) des soignants avaient utilise des antibiotiques non prescrits pour traiter les symptomes de leur enfant au cours des 6 mois precedents. Les symptomes frequemment soignes etaient la toux (84%), la fievre (66%), l'ecoulement nasal (65%) et le mal de gorge (60%). Uamoxicilline etait l'antibiotique le plus communement utilise (58%). Les pharmacies etaient la principale source (86%) d'approvisionnement ales antibiotiques non prescrits. L'administration d'antibiotiques sans ordonnance par les meres de famille etait largement associee au fait que ces medicaments etaient conserves a domicile (rapport des cotes, RC: 1,7; IC de 95%: 1,04-2,79), a l'automedication par les soignants (RC: 6,3; IC de 95%: 3,8-10,5) et a l'age plus eleve de l'enfant (RC: 1,02; IC de 95%: 1,01-1,04). Les adultes referents avec une meilleure connaissance des antibiotiques avaient moins tendance a administrer des antibiotiques non prescrits a leurs enfants (CR: 0,7; IC de 95%: 0,6-0,8). Conclusion La prevalence de l'utilisation d'antibiotiques non prescrits chez les jeunes enfants etait elevee a Oulan Bator. Cet usage abusif entrainant une augmentation de la resistance bacterienne aux antibiotiques, ainsi que des problemes de sante connexes, nos resultats ont des implications importantes pour l'information du grand public et l'application de reglementations en matiere de vente des antibiotiques en Mongolie. Objetivo Calcular la prevalencia e identificar los factores determinantes para la prescripcion de antibioticos de venta sin receta para ninos en Mongolia. Metodos Se realizo un estudio transversal de la comunidad en 10 subdistritos de Ulaanbaatar, la capital de Mongolia. Un cuestionario estructurado nos permitio recopilar los datos de una muestra aleatoria de 540 hogares, con ai menos un nino menor de 5 anos. Para identificar los factores asociados a la mala utilizacion de los antibioticos se empleo la regresion logistica. Resultados De los 503 cuidadores participantes, el 71% eran madres; el 42,3% (intervalo de confianza del 95%, IC: 37,8-46,9) de los cuidadores habia utilizado antibioticos sin receta en los ultimos 6 meses para tratar los sintomas de sus hijos. Los sintomas tratados mas habituales fueron: tos (84%), fiebre (66%), mucosidad nasal (65%) y dolor de garganta (60%). El antibiotico mas utilizado (58%) fue la amoxicilina. Los antibioticos de venta sin receta se obtuvieron principalmente (86%) en las farmacias. EI uso de farmacos de venta sin receta por parte de las madres se asocio de manera significativa a la permanencia de los antibioticos en el hogar (oportunidad relativa, OR: 1,7; CI del 95%: 1,04-2,79), la automedicacion de los cuidadores (OR: 6,3; Cl del 95%: 3,8-10,5) y a la edad del hijo mayor (OR: 1,02; CI del 95%: 1,01 -1,04). Los cuidadores que poseian conocimientos mas amplios sobre los antibioticos fueron menos proclives a administrar antibioticos sin receta a los ninos (OR: 0,7; CI del 95%: 0,6-0,8). Conclusion La prevalencia del uso de antibioticos sin prescripcion medica en los ninos mas pequenos fue elevada en Ulaanbaatar. Puesto que dicho uso conlleva un aumento de la resistencia bacteriana a los antibioticos y problemas relacionados con la salud, nuestros resultados tienen implicaciones importantes para la educacion publica y para la aplicacion de las normativas sobre la venta de antibioticos en Mongolia., Introduction The emergence and spread of resistance related to the irrational use of antibiotics is a major global public health problem. (1,2) The rapid increase in drug-resistant Streptococcus pneumoniae infections [...]