Browsing by Author "Gunasekera, K."

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    A malaria death due to an imported Plasmodium falciparum infection in Sri Lanka during the prevention of re-establishment phase of malaria
    (BioMed Central, 2023) Seneviratne, S.; Fernando, D.; Chulasiri, P.; Gunasekera, K.; Thenuwara, N.; Aluthweera, C.; Wijesundara, A.; Fernandopulle, R.; Mendis, K.; Wickremasinghe, R.
    BACKGROUND: Sri Lanka has maintained a rigorous programme to prevent the re-establishment of malaria ever since the disease was eliminated in October 2012. It includes efforts to sustain case surveillance to ensure early diagnosis and management of malaria. Yet, in April of 2023 the death occurred of an individual with imported malaria. CASE PRESENTATION: The deceased was a 37-year-old Sri Lankan male who returned to Sri Lanka on the 10th of April after a business trip to several countries including Tanzania. He was febrile on arrival and consulted three Allopathic Medical Practitioners in succession in his home town in the Western Province of Sri Lanka, over a period of 5 days starting from the very day that he arrived in the country. Malaria was not tested for at any of these consultations and his clinical condition deteriorated. On the evening of 14th of April he was admitted to the medical intensive care unit of a major private hospital in the capital city of Colombo with multiple organ failure. There, on a request by the treating physician blood was tested for malaria and reported early the next morning as Plasmodium falciparum malaria with a high parasitaemia (> 10%). The patient died shortly after on the 15th of April before any anti-malarial medication was administered. The deceased had been a frequent business traveller to Africa, but with no past history of malaria. He had not taken chemoprophylaxis for malaria on this or previous travels to Africa. DISCUSSION: The patient's P. falciparum infection progressed rapidly over 5 days of arriving in Sri Lanka leading to severe malaria without being diagnosed, despite him seeking healthcare from three different Medical Practitioners. Finally, a diagnosis of malaria was made on admission to an intensive care unit; the patient died before anti-malarial medicines were administered. CONCLUSIONS: This first death due to severe P. falciparum malaria reported in Sri Lanka after elimination of the disease was due to the delay in diagnosing malaria.
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    Screening for risk of obstructive sleep apnoea - results of an island wide survey in Sri Lanka
    (Journal of the Ceylon College of Physicians, 2019) Undugodage, C.; Amarasiri, L.; Kamalanathan, M.; Gunasinghe, W.; Sadikeen, A.; Fernando, A.; Wickremasinghe, R.; Gunasekera, K.
    INTRODUCTION: Obstructive sleep apnoea (OSA) is the commonest sleep related breathing disorder worldwide, but there is only limited community level data on the risk of OSA from South Asian countries. AIMS AND OBJECTIVES: This study assessed the community prevalence of persons at high-risk for OSA among Sri Lankan adults. METHODS: A randomly selected sample of adults from 7 (out of 9) provinces of Sri Lanka was screened using the Berlin Questionnaire (BQ). BQ has 3 categories related to snoring severity (category 1), excessive day time somnolence (category 2) and history of hypertension or obesity (category 3). Individuals were classified as high or low risk according to the category score. RESULTS: One thousand six hundred and eight adults (46.2% male) were screened, and 270 were classified as high risk for OSA {16.8%; 95% Cl 14.9 %-18.6% (15.1% in males; 18.3% in females, p >0.05)}. Of the high-risk individuals, 239 (88.5%) were category 1 positive, 142 (52.6%) category 2 positive and 202 (74.8%) category 3 positive. 49/577 (8.5%) among persons = or <40 years and 221/ 1031 (21.4%) among those >40 years were at high risk. 10.3% of the adults had a BMI ≥30 (5.7% of males, 14% of females p<0.001). Snoring was reported by 573 (35.6%) individuals; 120 of them (20.9%) had apneas during sleep. CONCLUSION: The prevalence of high risk for OSA in this Sri Lankan community survey is lower than that reported from Western countries and did not show a gender-related difference.