Browsing by Author "Gunaratne, I.E."

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    Detection of a case of Brugian Filariasis from Anuradhapura, a non-endemic district of Sri Lanka
    (Sri Lanka Medical Association, 2018) Mallawarachchi, C.H.; Gunaratne, I.E.; Ekanayaka, G.M.G.A.C.; Mallawarachchi, S.M.N.S.M.; Chandrasena, T.G.A.N.; Mendis, D.; de Silva, N.R.
    INTRODUCTION AND OBJECTIVES: In 2016, the WHO declared that lymphatic filariasis was no longer a public health problem in Sri Lanka. However low-grade persistence of bancroftian filariasis continues in all three endemic provinces, while brugian filariasis has re-emerged. The periodicity pattern of the re-emerged Brugia spp. suggests zoonotic origin. A canine survey done in the district of Anuradhapura found a moderately high prevalence (28.2%) of B. malayi infections in the Thirappane MOH area. Objective of the study was to investigate the threat of zoonotic B.malayi infections to humans in the Thirappane MOH area. METHODS: A cross sectional survey was done among all consenting residents of three randomly selected areas representing the three PHI areas of the Thirappane MOH. Residents were screened between 8.00 pm and 12.00 pm using night blood smears (NBS) and Brugia rapid test (BRT) for presence of anti-Brugia IgG4 antibodies. BRT was done selectively. Ethical and administrative clearance was obtained prior to the survey. RESULTS: A total of 752 individuals were screened by NBS; 176 of them were also screened by BRT. 193, 208 and 351 NBSs were done respectively in Thirappane, Galkulama and Mooriyankadawala PHI areas. One individual, a 25-year-old long-term resident of Mooriyankadawala PHI area was positive for Brugia spp. microfilariae by NBS and by BRT. The microfilariae exhibited nocturnal sub-periodicity. CONCLUSION: Transmission of brugian filariasis appears to occur even outside the traditional endemic belt. The presence of canine reservoirs of infection and water bodies with aquatic vegetation probably favour transmission by Mansonia spp. vector mosquitoes in the study area.
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    Morbidity management and disability prevention for lymphatic filariasis in Sri Lanka: Current status and future prospects
    (Public Library of Science, 2018) Chandrasena, N.; Premaratna, R.; Gunaratne, I.E.; de Silva, N.R.
    BACKGROUND: Sri Lanka was acknowledged to have eliminated lymphatic filariasis (LF) as a public health problem in 2016, largely due to its success in Mass Drug Administration (MDA) to interrupt disease transmission. Analysis of the Strengths, Weaknesses, Opportunities and Threats (SWOT) of the national Morbidity Management and Disability Prevention (MMDP) program, the other pillar of the LF control program, was carried out with the objective of evaluating it and providing recommendations to optimize the use of available resources. METHODOLOGY: A situation analysis of the MMDP activities provided by the state health sector was carried out using published records, in-depth interviews with key informants of the Anti Filariasis Campaign, site-visits to filariasis clinics with informal discussions with clinic workforce and personal communications to identify strengths and weaknesses; and opportunities to overcome weaknesses and perceived threats to the program were explored. The principal strength of the MMDP program was the filariasis clinics operational in most endemic districts of Sri Lanka, providing free health care and health education to clinic attendees. The weaknesses identified were the low accessibility of clinics, incomplete coverage of the endemic region and lack of facilities for rehabilitation. The perceived threats were diversion of staff and resources for control of other vector-borne infections, under-utilization of clinics and non-compliance with recommended treatment. Enhanced high level commitment for MMDP, wider publicity and referral systems, integration of MMDP with other disease management services and collaboration with welfare organizations and research groups were identified as opportunities to overcome weaknesses and challenges. CONCLUSIONS: The recommended basic package of MMDP was functional in most of the LF-endemic region. The highlighted weaknesses and challenges, unless addressed, may threaten program sustainability. The identified opportunities for improvement of the programme could ensure better attainment of the goal of the MMDP program, namely access to basic care for all affected by lymphatic filarial disease.