Cooperative Agreement Implementation Department of Health and Human Services, USA Centers for Disease Control and Prevention Ministry of Health, Mongolia National Center of Communicable Diseases ANNUAL REPORT: 2007/2008 covering the period from September 15, 2004 to September 14, 2008 of the Project “Development of Influenza Surveillance Network” approved by the Cooperative Agreement between DHHS/CDC, USA and MoH/NCCD, Mongolia Cooperative Agreement No: U50/CCU024411 PAN: B5265G1 1 B5265G1 Annual Report – 2007/2008 Content List of abbreviations used ...................................................................... 7 Foreword ............................................................................................ 9 One. Background............................................................................10 1.1. Geography and Climate of Mongolia .......................................... 10 1.2. Political System and Administrative Structure of Mongolia ......... 13 1.3. Demography and Main Health Indicators of Mongolia ............... 13 1.4. Health Service Delivery of Mongolia ...........................................15 1.5. USA/Mongolia Collaboration in Health Fields ........................... 16 1.6. History of the US/Mongolia Cooperative Agreement “Development of Influenza Surveillance Network” .....................17 Two. Influenza surveillance in Mongolia ............................................18 2.1. History ........................................................................................18 2.2. Current Surveillance System ....................................................... 21 2.3. Epidemiology of ILI in the last five seasons ................................. 23 2.3.1. Outpatient-based ILI surveillance ............................................... 23 2.3.2. Hospital-based pneumonia surveillance ........................................38 2.3.3. Laboratory Quality Assurance ......................................................40 Three. Cooperative Agreement Implementation: ..................................43 3.1. Project Goal ................................................................................43 3.2. Project Objectives ........................................................................ 43 3.3. Project Implementation Status as September 14, 2006 .................43 3.4. Project Implementation in the 2006/2007 and 2007-2008 season (status as September 14, 2008) ......................................................70 Four. Annexes .................................................................................96 Annex 1. IST Composition .................................................................. 96 Annex 2. ISAC Composition ............................................................... 96 Annex 3. ILI sentinel surveillance sites in the capital city ......................97 Annex 4. ILI sentinel surveillance sites in the provinces .......................98 Annex 5. Program of the 1st National Influenza Workshop (NIW1) September 8-9, 2005 ............................................................. 99 Annex 6. Participants’ list (204) of the NIW1 September 8-9, 2005, Ulaanbaatar .........................................................................101 Annex 7. Recommendation from NIW1 .............................................109 Annex 8. Unified program of training workshops for clinical ILI surveillance, 2004/2005 ........................................................112 Annex 9. Program of the Workshop in UB, April 16, 2005 ..................114 Annex 10. Participants list (30) of the training workshop in Selenghe province, January 9, 2005.....................................................115 2 Content Annex 11. Participants list (30) of the training workshop in Dornogovi province, January 9, 2005.....................................................116 Annex 12. Participants list (80) of the training workshop in UB, April 16, 2005 ......................................................................117 Annex 13. Participants list (30) of the training workshop in Uvurkhangai province, April 30, 2005 ..................................120 Annex 14. Participants list (30) of the training workshop in Dornod province, July 6, 2005 ..........................................................121 Annex 15. Participants list (30) of the training workshop in Khovd province, July 8, 2005 ..........................................................122 Annex 16. Equipment and Devices supplied to IST Epidemiology group in 2004/2005 season ...................................................123 Annex 17. Equipment and Devices supplied to IST Epidemiology group in 2005/2006 season ..................................................123 Annex 18. Training program for epidemiologists and public health professionals on “Influenza surveillance and prevention”, November 9, 2005 ................................................................124 Annex 19. Participants list of the training for epidemiologists and public health professionals on “Influenza surveillance and prevention”, November 9, 2005 ...........................................125 Annex 20. Training program of the workshop on absenteeism surveillance for heads of Ulaanbaatar city units, October 31, 2005 ...........127 Annex 21. Participants list of the workshop on absenteeism surveillance for heads of Ulaanbaatar city units, October 31, 2005 ...........128 Annex 22. Training program of the workshop on “Development of hospital based influenza surveillance”, November 25, 2005 ..129 Annex 23. Participants list of the workshop on “Development of hospital based influenza surveillance”, November 25, 2005 ...............130 Annex 24. Training program for physicians from FGP and Health Departments of Orkhon and Darkhan-Uul provinces, September 3-8, 2006 ............................................................132 Annex 25. Participans list of the training workshop for physicians from FGP and Health Departments of Orkhon and Darkhan-Uul provinces, September 3-8, 2006 ...........................................133 Annex 26. Training program for doctors of Ulaanbaatar city, November 2-4, 2005 ............................................................137 Annex 27. Participants list of the training workshop-1 for family doctors of Ulaanbaatar city, November 2, 2005 ....................138 Annex 28. Participants list of the training workshop-2 for doctors of Ulaanbaatar city, November 4, 2005 ....................................140 Annex 29. Laboratory and office equipment received in VL/NCCD in the fiscal year of 2004/2005 ..............................................141 Annex 30. Laboratory reagents and other consumables received in VL/ NCCD in the fiscal year of 2004/2005..................................143 3 B5265G1 Annual Report – 2007/2008 Annex 31. Laboratory and office equipment received in VL/NCCD in the fiscal year of 2005/2006 ..............................................145 Annex 32. Laboratory reagents and other consumables received in VL/ NCCD in the fiscal year of 2005/2006..................................145 Annex 33. Office equipment and devices supplied to Management team in 2005/2006 season ....................................................146 Annex 34. Training program of the workshop on “Need for establishment of biosafety III level laboratory”, November 23, 2005 ..........147 Annex 35. Participans list of the workshop on “Need for establishment of biosafety III level laboratory”, November 23, 2005 ..............148 Annex 36. Refrigerators and thermometers, tube stands and sockets supplied to sentinel sites in the fiscl year of 2005/2006 .........149 Annex 37. Training program of the workshop for veterinarians of Ulaanbaatar city, November 17, 2005 ..................................149 Annex 38. Partcipants list of the workshop for veterinarians of Ulaanbaatar city, November 17, 2005 ..................................150 Annex 39. Training program of the workshop for pharmacists of Ulaanbaatar city, November 18, 2005 ..................................150 Annex 40. Partcipants list of the workshop for pharmacists of Ulaanbaatar city, November 18, 2005 ..............................151 Annex 41. IST composition (approved by the order ¹253/2006 of the Minister of health, Mongolia) ..............................................152 Annex 42. ISAC composition (approved by the order ¹253/2006 of the Minister of health, Mongolia) ....................................152 Annex 43. ILI sentinel surveillance sites in the capital city (status as September 14, 2007) .............................................153 Annex 44. ILI sentinel surveillance sites in the provinces (status as September 14, 2007) .............................................155 Annex 45. Program of the 2nd National Influenza Workshop (NIW2) October 4-5, 2006 ...................................................158 Annex 46. Participants’ list (220) of the NIW2 October 4-5, 2006, Ulaanbaatar ...........................................161 Annex 47. Recommendation from NIW2 .............................................171 Annex 48. Recommendatoon of Dr. M. Tashiro, STC, WHO from NIID, Japan on strengthening of virology laboratory capacity .........172 Annex 49. Program of the workshop on hospital-based surveillance for medical doctors, September 2006 .........................................175 Annex 50. Participants’ list of the workshop on hospital-based surveillance for medical doctors of NCCD, September 20, 2006. .............................................................176