BackgroundNeonatal hyperbilirubinemia, especially kernicterus, can be prevented by screening for neonatal jaundice. The transcutaneous bilirubin (TcB) meter is a non-invasive medical device for screening neonates. The study aimed to investigate the validity of a TcB meter in a resource-limited setting such as Mongolia.MethodsTerm and late preterm neonates from the National Center for Maternal and Child Health of Ulaanbaatar in Mongolia who met the inclusion criteria (gestational age ≥35 weeks, birth weight ≥2000 g, postnatal age ≤ 1 month) were enrolled in the study. We used a TcB meter, JM-103 to screen for neonatal jaundice. TcB measurements at the infant’s forehead and midsternum were performed within 3 h of obtaining samples for total serum bilirubin (TSB) measurement. We analyzed the correlation between TcB measurements and TSB measurements to validate the meter.ResultsA total of 47 term and six late preterm neonates were included in the study. TcB measured by the meter at both the forehead and the midsternum showed a strong correlation with TSB measured in the laboratory. The correlation equations were TSB = 1.409+0.8655 × TcB (R2=0.78871) at the forehead, and TSB = 0.7555+0.8974 × TcB (R2=0.78488) at the midsternum. Bland-Altman plots and the Bradley-Blackwood test showed no significant differences between the two methods at all measured ranges of bilirubin. The mean areas under the curves of TcB at the forehead and midsternum at three TSB levels (>10 mg/dL, >13 mg/dL, >15 mg/dL) of TcB were greater than 0.9, and all had high sensitivity and specificity.ConclusionsThis study established the validity of the JM-103 meter as a screening tool for neonatal jaundice in term and late preterm infants in Mongolia. Future studies are needed, including the establishment of a TcB hour-specific nomogram, for more effective clinical practice to prevent severe hyperbilirubinemia.

Objective: This study investigated the use of a Maternal and Child Health (MCH) handbook, and related factors, in Mongolia. Design: Population-based cross-sectional study. Setting: Bulgan Province, Mongolia. Method: MCH handbook use was determined by examining whether participants had read it or recorded their health-related information into it. Multiple logistic regression analysis was performed to reveal factors related to MCH handbook utilisation. Results: Of the 716 participants, 631 (88.1%) read the MCH handbook and 428 (59.8%) recorded their health-related information in it. Mothers with middle or high educational attainment were more likely to have read it than were those with low educational attainment (adjusted odds ratio [AOR] = 2.52, 95% confidence interval [CI] = 1.41–4.50; AOR = 3.19, 95% CI = 1.29–7.93, respectively). Literate women and those who had been taught to use the handbook were more likely to read it (AOR = 3.19, 95% CI = 1.68–6.05; AOR = 2.42, 95% CI = 1.31–4.46, respectively). Mothers with a middle or very high wealth index were more likely to have read it than were those with a very low index. Mothers with middle or high educational attainment were more likely to make records in it than were those with low attainment. Mothers who were taught to use the handbook were more likely to make records in it, while those who had children with chronic diseases were less likely to do so. Conclusion: Women’s literacy levels, educational attainment, economic status and effective explanation of its usage must be considered in order to enhance the handbook’s effectiveness.

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This study aimed to assess the potential risk factors for lower respiratory tract infection (LRTI)-related hospital admissions in Mongolian children. A population-based cross-sectional study was conducted in rural Mongolia in 2013, and 1,013 mother–child pairs were included. Of the participating children, 38.9% were admitted to hospital with LRTIs. Home smoking, low birthweight, being a male child, exclusive breastfeeding and healthcare-seeking behaviour showed substantial association with LRTI-related hospital admissions. Number of cigarettes smoked by family members showed a dose-response relationship and increased hospital admissions. Strategies to prevent second-hand-smoke exposure from adult smokers, especially inside the home, are crucial to preventing LRTI-related hospital admissions for children in Mongolia. Improving rates of exclusive breastfeeding and increasing birthweight have great potential to decrease the likelihood of children acquiring a LRTI. Educational initiatives are also necessary for women who are less likely to seek out care for their children’s symptoms.