Mongolian visit at Karolinska Huddinge and Chorus

Recently, we had a visit from Mongolia to the Chorus office in Stockholm.  

Mongolian doctors and researchers from the Onom Foundation have together with Swedish nurses, doctors, and researchers from Karolinska University Hospital (led by Professor Soo Aleman), conducted a screening event and study named “Find the Missing Thousands – Stockholm” regarding Hepatitis B, C and D among Mongolian citizens.  
We were glad to have Dr. Ochirmaa Narantsogt, Mr.Sanjaasuren and Dr. Delgersaikhan Zulkhuu at our office. They kindly told us more about the study and the challenges they are tackling.
The picture above, shows Dr. Naranbaatar Dashdorj, Chairman of the Board of Onom Foundation, giving a lecture to a group of people who were waiting to be screened during the event.

Why hepatitis? And why Stockholm?

Mongolia has very high rates of hepatitis B, C and D, and persons with these infections have high risk to develop liver cirrhosis and liver cancer.

Chronic viral hepatitis B, C, and D are endemic in Mongolia and are the primary cause of the country's highest liver cancer mortality rate in the world.  

In 2014, the Hepatitis Prevention, Control, and Elimination (HPCE) Program was initiated by the Onom Foundation, Patient and Civil Society Council, Mongolian Gastroenterology Association, and Mongolian Society of Hepatology. The Government of Mongolia adopted the HPCE Program into the 2016-2020 Action Plan on September 9, 2016, thanks to the persistent efforts of these organizations.  Within the scope of this program, 1.2 million adults screened for hepatitis B and C, revealing that the hepatitis B prevalence rate among Mongols was 11.1%, whereas the hepatitis C prevalence rate was 8.5%.

A good initiative going wrong

Why is it so? Back in the 1930s, the Russians started a comprehensive vaccination program to prevent typhoid fever, called” The Red Injection Campaign”.  Presumably, in these days, awareness was limited regarding the dangers of syringe reuse, and hepatitis may have spread as a result of this initiative!  

Source: The Lancet, "Mongolia's struggle with liver cancer", April 2011

A widespread and dangerous problem

Mongolia has the highest incidence of liver cancer per capita in the world. And we have the largest Mongolian population of all European cities here in Stockholm.  

There is a national screening and vaccination program for Hepatitis B in place in Mongolia since 1991, so the younger generation is comparatively safe. But there is still an older population that needs to be tested.  

“Find a Missing Thousands – Stockholm” is part of a larger international initiative with studies conducted in Los Angeles and Chicago. There are also plans for similar activities in Lyon, Paris and Sydney, Australia.

Very positive response

When the study was announced, 1,000 people pre-registered in Stockholm. The expected turnout was originally estimated to be around 200 - but nearly 900 persons eventually showed up for testing! This was partly thanks to social media, word-of-mouth and worries because of relatives that have died of liver cancer. Therefore, the Mongolian/Swedish team had a very busy, but satisfying, weekend! Because of this successful turn-out, Onom Foundation and Karolinska Huddinge are considering scheduling follow-up events, to increase the coverage of screening the Mongolian population living here in Stockholm.