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1. Patients’ priorities around drug-resistant tuberculosis treatment: A multi-national qualitative study from Mongolia, South Africa and Georgia

Author

Annabelle South, Parveen Dhesi, Conor D. Tweed, Bazarragchaa Tsogt, Suzanne Staples, Nestani Tukvadze, Gantsetseg Dorj, Sindisiwe Zaca, Ekaterine Sanikidze, Nasanjargal Purev, Hanif Esmail, and Rochelle Burgess

Subjects
drug-resistant tuberculosis, treatment experience, qualitative research, Public aspects of medicine, RA1-1270
Abstract

We conducted qualitative research exploring the treatment experience of people with DR-TB. We held nine focus group discussions with 57 adults undergoing/recently completed treatment for DR-TB in Georgia, Mongolia and South Africa. Translated transcripts were analysed using thematic analysis. We identified three higher order themes: (1) Treatment experience and the role of good relationships with healthcare providers: Treatment duration, pill burden and side-effects were challenging aspects of treatment. Side-effects/symptoms that were visible signs of illness were particularly troubling. Good relations with clinical staff helped combat fear and uncertainty regarding treatment. (2) Mental distress and opportunities for wellbeing: The shame, stigma and isolation people experienced as a result of their DR-TB diagnosis was an important cause of mental distress. No longer being infectious enabled people to resume work and socialising. Positive emotions emerged with good treatment outcomes. (3) Fear and worry along the treatment journey: Participants expressed fears about TB: infecting others; whether they would be able to endure treatment; side-effects; health consequences of treatment. Worries mostly disappeared with successful treatment. Alongside measuring side-effects, time to culture conversion and cure rates, future trials of DR-TB treatments should capture how quickly visible symptoms resolve, quality of life measures, and mental health outcomes.

Published
2023
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2. Priority Activities in Child and Adolescent Tuberculosis to Close the Policy-Practice Gap in Low- and Middle-Income Countries

Author

Karen du Preez, Betina Mendez Alcântara Gabardo, Sushil K. Kabra, Rina Triasih, Trisasi Lestari, Margaret Kal, Bazarragchaa Tsogt, Gantsetseg Dorj, Enkhtsetseg Purev, Thu Anh Nguyen, Lenny Naidoo, Lindiwe Mvusi, Hendrik Simon Schaaf, Anneke C. Hesseling, Andrea Maciel de Oliveira Rossoni, Anna Cristina Calçada Carvalho, Claudete Aparecida Araújo Cardoso, Clemax Couto Sant’Anna, Danielle Gomes Dell’ Orti, Fernanda Dockhorn Costa, Liliana Romero Vega, Maria de Fátima Pombo Sant’Anna, Nguyen Binh Hoa, Phan Huu Phuc, Attannon Arnauld Fiogbe, Dissou Affolabi, Gisèle Badoum, Abdoul Risgou Ouédraogo, Tandaogo Saouadogo, Adjima Combary, Albert Kuate Kuate, Bisso Ngono Annie Prudence, Aboubakar Sidiki Magassouba, Adama Marie Bangoura, Alphazazi Soumana, Georges Hermana, Hervé Gando, Nafissatou Fall, Barnabé Gning, Mohammed Fall Dogo, Olivia Mbitikon, Manon Deffense, Kevin Zimba, Chishala Chabala, Moorine Penninah Sekadde, Henry Luzze, Stavia Turyahabwe, John Paul Dongo, Constantino Lopes, Milena dos Santos, Joshua Reginald Francis, Magnolia Arango-Loboguerrero, Carlos M. Perez-Velez, Kobto Ghislain Koura, and Stephen M. Graham

Subjects
tuberculosis, child, adolescent, national tuberculosis program, Medicine
Abstract

Over the past 15 years, and despite many difficulties, significant progress has been made to advance child and adolescent tuberculosis (TB) care. Despite increasing availability of safe and effective treatment and prevention options, TB remains a global health priority as a major cause of child and adolescent morbidity and mortality—over one and a half million children and adolescents develop TB each year. A history of the global public health perspective on child and adolescent TB is followed by 12 narratives detailing challenges and progress in 19 TB endemic low and middle-income countries. Overarching challenges include: under-detection and under-reporting of child and adolescent TB; poor implementation and reporting of contact investigation and TB preventive treatment services; the need for health systems strengthening to deliver effective, decentralized services; and lack of integration between TB programs and child health services. The COVID-19 pandemic has had a significant negative impact on case detection and treatment outcomes. Child and adolescent TB working groups can address country-specific challenges to close the policy–practice gaps by developing and supporting decentral ized models of care, strengthening clinical and laboratory diagnosis, including of multidrug-resistant TB, providing recommended options for treatment of disease and infection, and forging strong collaborations across relevant health sectors.

Published
2022
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3. Isolation and Identification of a Highly Pathogenic Avian Influenza H5N6 Virus from Migratory Waterfowl in Western Mongolia

Author

Ganzorig Basan, Ulaankhuu Ankhanbaatar, Delgerzul Gombo-Ochir, Charles Euloge Lamien, Sneha Datta, Buyantogtokh Khanui, Tirumala B. K. Settypalli, William G. Dundon, Tserenchimed Sainnokhoi, Gantsetseg Dorj, and Giovanni Cattoli

Subjects
Whole genome sequencing, Anser cygnoides, Ecology, Zoology, Animals, Wild, Subclade, Mongolia, Biology, medicine.disease_cause, Isolation (microbiology), biology.organism_classification, Influenza A virus subtype H5N1, Virus, Ducks, Goose, Influenza A virus, Whooper swan, Influenza in Birds, biology.animal, medicine, Animals, Phylogeny, Ecology, Evolution, Behavior and Systematics
Abstract

In April 2020, two Whooper Swans (Cygnus cygnus) and one Swan Goose (Anser cygnoides) were found dead at three different locations in western Mongolia. Virus isolation from organs taken from the carcasses and full genome sequencing revealed that all three birds were positive for highly pathogenic H5N6 avian influenza virus (HPAIV) belonging to subclade 2.3.4.4h. Confirming similar reports from central Mongolia and western China, these findings have important implications for the monitoring, control, and management of HPAIVs in wild bird and commercial poultry populations in Mongolia.

Published
2022

4. Priority Activities in Child and Adolescent Tuberculosis to Close the Policy-Practice Gap in Low- and Middle-Income Countries

Author

Karen du Preez, Betina Mendez Alcântara Gabardo, Sushil K. Kabra, Rina Triasih, Trisasi Lestari, Margaret Kal, Bazarragchaa Tsogt, Gantsetseg Dorj, Enkhtsetseg Purev, Thu Anh Nguyen, Lenny Naidoo, Lindiwe Mvusi, Hendrik Simon Schaaf, Anneke C. Hesseling, Andrea Maciel de Oliveira Rossoni, Anna Cristina Calçada Carvalho, Claudete Aparecida Araújo Cardoso, Clemax Couto Sant’Anna, Danielle Gomes Dell’ Orti, Fernanda Dockhorn Costa, Liliana Romero Vega, Maria de Fátima Pombo Sant’Anna, Nguyen Binh Hoa, Phan Huu Phuc, Attannon Arnauld Fiogbe, Dissou Affolabi, Gisèle Badoum, Abdoul Risgou Ouédraogo, Tandaogo Saouadogo, Adjima Combary, Albert Kuate Kuate, Bisso Ngono Annie Prudence, Aboubakar Sidiki Magassouba, Adama Marie Bangoura, Alphazazi Soumana, Georges Hermana, Hervé Gando, Nafissatou Fall, Barnabé Gning, Mohammed Fall Dogo, Olivia Mbitikon, Manon Deffense, Kevin Zimba, Chishala Chabala, Moorine Penninah Sekadde, Henry Luzze, Stavia Turyahabwe, John Paul Dongo, Constantino Lopes, Milena dos Santos, Joshua Reginald Francis, Magnolia Arango-Loboguerrero, Carlos M. Perez-Velez, Kobto Ghislain Koura, and Stephen M. Graham

Subjects
Microbiology (medical), Infectious Diseases, General Immunology and Microbiology, Immunology and Allergy, Molecular Biology
Abstract

Over the past 15 years, and despite many difficulties, significant progress has been made to advance child and adolescent tuberculosis (TB) care. Despite increasing availability of safe and effective treatment and prevention options, TB remains a global health priority as a major cause of child and adolescent morbidity and mortality—over one and a half million children and adolescents develop TB each year. A history of the global public health perspective on child and adolescent TB is followed by 12 narratives detailing challenges and progress in 19 TB endemic low and middle-income countries. Overarching challenges include: under-detection and under-reporting of child and adolescent TB; poor implementation and reporting of contact investigation and TB preventive treatment services; the need for health systems strengthening to deliver effective, decentralized services; and lack of integration between TB programs and child health services. The COVID-19 pandemic has had a significant negative impact on case detection and treatment outcomes. Child and adolescent TB working groups can address country-specific challenges to close the policy–practice gaps by developing and supporting decentral ized models of care, strengthening clinical and laboratory diagnosis, including of multidrug-resistant TB, providing recommended options for treatment of disease and infection, and forging strong collaborations across relevant health sectors.

Published
2021

6. Representative Seroprevalences of Human and Livestock Brucellosis in Two Mongolian Provinces

Author

Zolzaya, Baljinnyam, Selenge, Tsend, Narangarav, Tsegeen, Gantsetseg, Dorj, Erdenechimeg, Dashzevge, Zinsstag, Jakob, Schelling, Esther, Zolzaya, Baljinnyam, Selenge, Tsend, Narangarav, Tsegeen, Gantsetseg, Dorj, Erdenechimeg, Dashzevge, Zinsstag, Jakob, and Schelling, Esther

Abstract

Mongolia implemented a brucellosis livestock mass vaccination campaign from 2000 to 2009. However, the number of human cases did not decline since 2004 and the current epidemiological situation in Mongolia was uncertain. The objective of this study was to estimate the representative seroprevalences of humans and livestock in two provinces in view of their comparison with officially reported data. A representative cross-sectional study using cluster sampling proportional to size in humans, sheep, goats, cattle, yaks, horses, camels and dogs was undertaken to assess the apparent seroprevalence in humans and animals. A total of 8054 livestock and dog sera and 574 human sera were collected in Sukhbaatar and Zavkhan provinces. Human and animal sera were tested with the Rose Bengal and ELISA tests. The overall apparent seroprevalence of brucellosis was 27.3% in humans (95% CI 23.7-31.2%), 6.2% (95% CI 5.5-7.1%) in sheep, 5.2% (95% CI 4.4-5.9%) in goats, 16.0% (95% CI 13.7-18.7%) in cattle, 2.5% (95% CI 0.8-7.6%) in camels, 8.3 (95% CI 6.0-11.6%) in horses and 36.4% (95% CI 26.3-48.0%) in dogs. More women than men were seropositive (OR=1.7; P<0.0014). Human seroprevalence was not associated with small ruminant and cattle seroprevalence at the nomadic camp (hot ail) level. Annual incidence of clinical brucellosis, inferred from the seroprevalence using a catalytic model, was by a factor of 4.6 (1307/280) in Sukhbaatar and by a factor of 59 (1188/20) in Zavkhan. This represents a 15-fold underreporting of human brucellosis in Mongolia. The lack of access to brucellosis diagnostic testing at the village level hinders rural people from receiving appropriate treatment. In conclusion, this study confirms the high seroprevalence of human and livestock brucellosis in Mongolia. Stringent monitoring and quality control of operational management of a nationwide mass vaccination of small and large ruminants is warranted to assure its effectiveness. More research is needed to understan

Published
2019

7. Retrospective Analysis of Sheep Scrapie by Western Blotting with Formalin-Fixed Paraffin-Embedded (FFPE) Tissues

Author

Kumiko Kimura, Kohtaro Miyazawa, Gantsetseg Dorj, Hiroyuki Okada, Kentaro Masujin, Shirou Mohri, and Takashi Yokoyama

Subjects
Gene isoform, Pathology, medicine.medical_specialty, Paraffin Embedding, Sheep, Tissue Fixation, PrPSc Proteins, General Veterinary, Formalin fixed paraffin embedded, medicine.drug_class, animal diseases, Blotting, Western, Scrapie, Biology, Monoclonal antibody, nervous system diseases, Blot, Formaldehyde, Retrospective analysis, medicine, Animals, Prion protein, Retrospective Studies
Abstract

An abnormal isoform of prion protein (PrP(Sc)) was extracted from formalin-fixed paraffin-embedded (FFPE) tissues from sheep and analyzed by western blotting. PrP(Sc) immunoreactivity against anti-PrP monoclonal antibody T2, which recognizes discontinuous PrP sequences, differed amongst individual scrapie sheep cases. This may reflect structural differences in PrP(Sc) that have been formalin-fixed prior to their extraction. This study indicates that western blotting by using FFPE tissues is useful for the retrospective analysis of transmissible spongiform encephalopathies in which only formalin-fixed samples are available and in conducting transmissible spongiform encephalopathies surveillance where freezing system is insufficient.

Published
2012

9. Retrospective Analysis of Sheep Scrapie by Western Blotting with Formalin-Fixed Parafin-Embedded (FFPE) Tissues.

Author

Gantsetseg DORJ, Hiroyuki OKADA, Kohtaro MIYAZAWA, Kentaro MASUJIN, Kumiko KIMURA, Shirou MOHRI, and Takashi YOKOYAMA

Subjects
WESTERN immunoblotting, CHRONIC wasting disease, PRION diseases in animals, SHEEP diseases, RETROSPECTIVE studies
Abstract

The article discusses a study demonstrating that Western blotting (WB) analysis by employing formalin-fixed paraffin-embedded (FFPE) tissues will be helpful for retrospective analysis in which only formalin-fixed samples are available in conducting transmissible spongiform encephalopathies (TSE) surveillance where freezing system is deficient. A table showing the abnormal isoform of prion protein (PrPSc) detection from FFPE tissues of scrapie sheep is presented.

Published
2012
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10. Representative Seroprevalences of Human and Livestock Brucellosis in Two Mongolian Provinces

Author

Zolzaya, Baljinnyam, Selenge, Tsend, Narangarav, Tsegeen, Gantsetseg, Dorj, Erdenechimeg, Dashzevge, Zinsstag, Jakob, Schelling, Esther, Zolzaya, Baljinnyam, Selenge, Tsend, Narangarav, Tsegeen, Gantsetseg, Dorj, Erdenechimeg, Dashzevge, Zinsstag, Jakob, and Schelling, Esther

Abstract

Mongolia implemented a brucellosis livestock mass vaccination campaign from 2000 to 2009. However, the number of human cases did not decline since 2004 and the current epidemiological situation in Mongolia was uncertain. The objective of this study was to estimate the representative seroprevalences of humans and livestock in two provinces in view of their comparison with officially reported data. A representative cross-sectional study using cluster sampling proportional to size in humans, sheep, goats, cattle, yaks, horses, camels and dogs was undertaken to assess the apparent seroprevalence in humans and animals. A total of 8054 livestock and dog sera and 574 human sera were collected in Sukhbaatar and Zavkhan provinces. Human and animal sera were tested with the Rose Bengal and ELISA tests. The overall apparent seroprevalence of brucellosis was 27.3% in humans (95% CI 23.7-31.2%), 6.2% (95% CI 5.5-7.1%) in sheep, 5.2% (95% CI 4.4-5.9%) in goats, 16.0% (95% CI 13.7-18.7%) in cattle, 2.5% (95% CI 0.8-7.6%) in camels, 8.3 (95% CI 6.0-11.6%) in horses and 36.4% (95% CI 26.3-48.0%) in dogs. More women than men were seropositive (OR=1.7; P<0.0014). Human seroprevalence was not associated with small ruminant and cattle seroprevalence at the nomadic camp (hot ail) level. Annual incidence of clinical brucellosis, inferred from the seroprevalence using a catalytic model, was by a factor of 4.6 (1307/280) in Sukhbaatar and by a factor of 59 (1188/20) in Zavkhan. This represents a 15-fold underreporting of human brucellosis in Mongolia. The lack of access to brucellosis diagnostic testing at the village level hinders rural people from receiving appropriate treatment. In conclusion, this study confirms the high seroprevalence of human and livestock brucellosis in Mongolia. Stringent monitoring and quality control of operational management of a nationwide mass vaccination of small and large ruminants is warranted to assure its effectiveness. More research is needed to understan

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