Browsing by Author "Jayawardana, P.L."

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Audiometry in brass workers
(College of Community Physicians of Sri Lanka, 2003) Jayawardana, P.L.; de Alwis, W.R.
OBJECTIVES : To compare hearing impairment among brass workers with that of the general population. Study DESIGN - A cross sectional analytical design METHODOLOGY : One hundred and seventy male brass workers and 170 controls from the general population were selected as subjects. The control group was matched for the age of the brass workers. A questionnaire was used to extract socio demographic and relevant data related to hearing impairment. Pure tone audiometry was carried out in the order of 1000, 1500, 2000, 3000, 4000, 6000, 8000, 250, 500 and 1000 Hz for both ears. Noise levels were measured in 10 randomly selected brass workshops. RESULTS : The number of pairs included in the analysis was 154. Tinnitus and subjective hearing impairment were present in 1 (0.6%) and 18 (1 1.7%) respectively among brass workers while the respective figures in the control group were 3 (1.9%) and 13 (8.4%) the differences of which were not significant. Brass workers had ORR of 3 (95%CI of 1.6 -5.8) and 4.9 (95% CI = 2.3-10.4) for overall hearing impairment in the left and right ears respectively. On multiple logistic regression, being a brass worker in all frequencies except 1000 Hz. and advancing age in the frequencies of 3000 to 6000 Hz. were found to be risk factors . The duration of service was found be a risk factor in the frequencies of 3000 and 4000 Hz when data pertaining to brass workers alone were analysed. The noise levels in the workshops ranged between 84 dB to 103 dB. CONCLUSIONs : Brass workers were at a higher risk of hearing impairment due to the prevalent high noise levels. Cheap and effective preventive measures are recommended.
Developing and validating a tool to assess empowerment for tobacco control
(Sri lanka Medical Association, 2015) Perera, K.M.N.; Guruge, G.N.D.; Jayawardana, P.L.
INTRODUCTION AND OBJECTIVES: Empowerment is defined as the mechanism by which individuals, organizations and communities gain mastery over their lives. Many tobacco control interventions aim to empower individuals but measuring empowerment is a challenge. Study aim was to develop a tool to assess empowerment for tobacco controf at individual level in the Moneragala District. METHOD: indicators were operationalized based on Zimmerman's psychological empowerment definition. Initial interviewer-administered tool was subjected to modified Delphi technique to determine content and consensual validity and a scoring system. Cognitive interviews were conducted to assess applicability to local context. Pre testing (n=30) and validation (n=200) were conducted in the Badulla District. Exploratory factor analysis was performed to assess construct validity. Based on communalities, Scree test and Eigenvalues derived from latter, Delphi technique was used to determine the factor structure which improved interpretability. Internal consistency and test-retest reliability were assessed using Cronbach's alpha and Cohen's kappa coefficient respectively. RESULTS: Components extracted using principle component analysis showed high communalities (0.914 to 0.996). Eigenvalue cut-off taken was 0.3 and six constructs based on the Scree plot converged in 14 iterations in Varimax rotation. Final tool comprised 27 items under seven factors named "Perceived awareness"; "Motivation to involve and perceived mastery"; "Awareness and mobilization of resources"; "Perceived efficacy"; "Perceived competence in society", “perceived competence within network” and “community involvement” for tobacco control. Cronbach’s alpha was 0.91 demonstrating good internal consistency. Cohen’s kappa coefficient was 0.63 indiicating substancial agreement .CONCLUSION: Developed tool can be used in similar contexts to measure empowerment for tobacco control.
Effectiveness of a community based health educational intervention in reducing unmet need for modern methods of family planning among ever married reproductive age women in the Kalutara district, Sri Lanka
(Insight Medical Publishing, 2012) Malwenna, L.I.; Jayawardana, P.L.; Balasuriya, A.
INTRODUCTION: Unmet need is defined as the percentage of all fecund women who are married or living in union and thus presumed to be sexually active but are not using any method of contraception, either do not want to have any more children or want to postpone their next birth at least for two more years or do not know when or if they want another child 1. Unmet Need for Modern Methods includes all in the unmet need group and those who are using natural and traditional methods at the time of survey (The Westoff Model) 2. It describes the discrepancy between sexual and contraceptive behaviors and stated fertility preferences of women in the reproductive age. OBJECTIVE: This study was designed to evaluate the effectiveness of a health educational intervention in improving the knowledge and attitudes on family planning (FP) among Public Health Midwives (PHMM) who function as community health workers and acceptance of modern FP methods planning which eventually reduce the Unmet Need (UMN) and thereby reducing the risk of unintended pregnancy among 15 - 49 year old married women in in the Kalutara district. METHOD: Initially the perceptions on unmet need in community service providers was assessed by three Focus Group Discussions conducted among Medical Officers of Health, Public Health Nursing Sisters and PHMM. It was followed by assessment of the baseline knowledge and attitudes on FP and UMN among all the PHMM and a group of married women in reproductive age (15-49) with unmet need for modern methods selected from cluster sampling of PHM areas in the district using PPS technique, allocating 22 clusters of 12 women in each Intervention (IA) and Control Area (CA).The developed health education intervention was applied on PHMM followed by the selected group of women with unmet need for modern methods only to the IA. The effectiveness was assessed in terms of the change in knowledge and attitudes of PHMM after 2 months of intervention, of target group of women after 6 months of intervention and the reduction of unmet need for modern methods in the IA compared to CA. RESULT: In PHMM, overall percentage mean knowledge score in IA at pre and post intervention were 29.9% and 65.7% respectively with a statistically significant difference (p<0.001) but with no such difference (p=0.10) in CA between pre (20%) and post (30%) scores. Median attitude scores were 37.5% and 86% in IA at pre and post intervention with a statistically significant difference (p<0.001). For CA respective figures were (40%) and (41%) with no significant difference (p=0.09) Regarding the target group, in IA had pre (37.6%) and post (70.6%) mean knowledge scores with a statistically significant difference (p<0.001); but with no significant difference (p=0.06) in CA between pre (39.0%) and post (40.2%) scores. Similarly, between groups comparison shows statistically significant difference (p<0.001) between IA and CA in post intervention, the scores being 70.6% and 40.2% respectively. CONCLUSION: The training conducted on PHMM revealed a significant impact on knowledge and attitudes in both service providers and clients leading to change in the FP practice and reduction in unmet need for modern methods of FP. AUTHOR KEYWORDS: Family planning; Health education intervention; Married women; Reproductive age; Unmet need
Effectiveness of an educational intervention among public health midwives on breast cancer early detection in the district of Gampaha, Sri Lanka.
(Asian Pacific Organization for Cancer Prevention, 2015) Vithana, P.V.; Ariyaratne, M.A.; Jayawardana, P.L.
BACKGROUND: Breast cancer is the commonest cancer among Sri Lankan females, accounting for 26% of the cancer incidence in women. Early detection of breast cancer is conducted by public health midwives (PHMs) in the Well Woman Clinics. The aim of the present study was to determine the effectiveness of an educational intervention on improving knowledge, attitudes and practices (KAP) on breast cancer screening among PHMs in the district of Gampaha. MATERIALS AND METHODS: Two Medical Officer of Health (MOH) areas in Gampaha district were selected using random sampling as intervention (IG) and control (CG) groups. All the PHMs in the two MOH areas participated in the study, with totals of 38 in IG and 47 in CG. They were exposed to an educational intervention with the objective of using them to subsequently conduct the same among 35-59 year women in the community. Following the intervention, post-intervention assessments were conducted at one month and six months to assess the effectiveness of the intervention. RESULTS: The overall median scores for KAP among PHMs respectively were as follows. Pre-intervention: IG:58%(IQR: 53- 69%), 90%(IQR: 70-100%) and 62%(IQR: 57-70%). CG: 64%(IQR: 56-69%), 90%(IQR: 70-90%) and 62%( IQR: 50-77%). Post-intervention: one month, IG:96%(IQR: 93-96%), 100%(IQR: 100-100%), and 85%(IQR: 81-89%). CG:67%(IQR: 60- 73%), 90%(IQR: 80-100%) and 65%(IQR: 50-73%). Post-intervention: six months, IG: 93% (IQR: 91-93%), 100%(IQR: 90- 100%), and 81%(IQR: 77-89%). CG: 67%(IQR: 58- 71%), 90%(IQR: 90-100%), and 62%( IQR: 58-73%). All the above post-intervention scores of PHMs in the IG were significantly higher in comparison to CG (p<0.001). CONCLUSIONS: This planned educational intervention had a significant impact on improving KAP of PHMs for early detection of breast cancer in the Gampaha district.
Emotional and behavioral status and associated factors among inmates aged 11-16 years of Children’s Homes in the Gampaha Probationary Division
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2016) Manori, D.M.S.; Jayawardana, P.L.
BACKGROUND: Emotional and behavioral disorders are common among inmates of Children’s Homes due to lack of love, affection and care available compared to their counterparts living with parents. OBJECTIVE: To describe the emotional and behavioral status and the associated factors among inmates aged 11-16 years of Children’s Homes in the Gampaha Probationary Division. METHODS: This was a descriptive cross sectional study. All eligible inmates of 14 Children’s Homes in Gampaha Probationary Division were recruited. Study instruments comprised, self-rated Strengths and Difficulties Questionnaire, interviewer administered questionnaire on socio demographic and other relevant factors and a checklist. Associations were tested using chi square test. A probability of <0.05 was considered significant. The results were expressed as odds ratios (OR) and 95% confidence intervals (95% CI). RESULTS: Response rate was 100% (n=279). The prevalence of abnormal emotional and behavioral status (E&BS) was 26.2% (95% CI: 21.1-31.7). Conduct problems were the highest (28.7%; 95% CI: 23.4-34.4) and prosocial problems were the lowest (3.6%; 95% CI: 1.7-6.5). Female sex (OR= 3.1; 95% CI: 1.7-5.9, p<0.001), living in Children’s Homes for more than six years (OR= 2.1; 95% CI: 1.1–4.0, p= 0.01), having less than 10 friends (OR= 1.8; 95% CI: 1.03-3.1, p = 0.04) and keeping problems to themselves (OR= 8.2; 95% CI: 3.5-19.7, p<0.001) were significantly associated with having abnormal E&BS. CONCLUSIONS: Observed prevalence of E&BS was higher than figures from general population which was 18.9%. Except “sex”, all other associated factors are modifiable. Recommend early screening and establishment of counseling services.
Household expenditure on tobacco consumption in a poverty-stricken rural district in Sri Lanka
(SAGE Publications, 2017) Perera, K.M.N.; Guruge, G.N.; Jayawardana, P.L.
Tobacco is a determinant of poverty and a barrier for development. Monaragala, a rural, agricultural district, reports the highest poverty-related indicators in southern Sri Lanka. A cross-sectional study was used to describe the household expenditure on tobacco and its association with food- and education-related expenditures at household level. This study used a 4-stage cluster sampling method to recruit a representative sample of 1160 households. Response rate was 98.6%. Median monthly household income was LKR 20 000 (interquartile range [IQR] = LKR 12 000-30 000). The median monthly expenditure on tobacco was LKR 1000 (IQR = LKR 400-2000) with the highest spending tertile reporting a median of LKR 2700 (IQR = LKR 2000-3600).The proportionate expenditure from the monthly income ranged from 0.0% to 50% with a median of 5.0% (IQR = 2.0-10.0) and a mean of 7.4% (7.6). The poorest reported the highest mean proportionate expenditure (9.8%, SD = 10) from the household income. Household expenditure on tobacco negatively associated with expenditure on education.
Household expenditure on tobacco consumption in Monaragala district
(Sri Lanka Medical Association, 2016) Perera, K.M.N.; Guruge, G.N.D.; Jayawardana, P.L.
INTRODUCTION AND OBJECTIVES: The link between tobacco and poverty is well established. Monaragala is the poorest rural district in the southern parts of Sri Lanka and second poorest in the country. The Central Bank statistics state that 2.7% of household expenditure is spent on “liquor, drugs and tobacco”. This figure is much lower than the global estimates and findings in other countries. This study aimed to describe the expenditure on tobacco and its impact on food and education related expenditures at household level in Monaragala District. METHOD: A cross-sectional study design was used. A representative sample of 1160 households was recruited using a four-stage cluster sampling method. A simple random sampling method was used to select an individual aged between 15 to 59 years from the selected household. Data were obtained by a pre-tested, validated questionnaire was administered by trained interviewers. Recall method was used to obtain expenditure related data. RESULTS: Median monthly household income was LKR 20,000 (IQR=LKR 12,000-30,000). The median monthly expenditure on tobacco was LKR 1000 (IQR: 400-2000) with the highest spending tertile reporting a median of LKR 2700 (IQR 2000-3600). The proportionate expenditure from the monthly income ranged from 0.0% to 50% with a median of 5.0% (IQR=2.0-10.0). The poorest reported the highest mean proportionate expenditure (9.8%, SD=10) from the household income. Medium and high spenders spent significantly less on children’s education compared to others. CONCLUSION: The household expenditure on tobacco products in rural poor communities in Sri Lanka is probably greater than the current estimates.
Knowledge of basic epidemiological and statistical concepts among doctors in selected Sri Lankan hospitals
(College of Community Physicians of Sri Lanka, 2010) Abeysena, H.T.C.S.; Jayawardana, P.L.; Wickremasinghe, A.R.; Wickramasinghe, U.
INTRODUCTION: This study was conducted to describe the ability to comprehend basic epidemiologic and statistical concepts among doctors in selected hospitals in the Western Province. METHODOLOGY: A cross-sectional descriptive study was conducted during January to February, 2008. The study population consisted of 315 doctors - 43 (13.7%) specialists, 50 (16%) postgraduate trainees (PG) and 222 (70.3%) grade medical officers. A self administered questionnaire was used to assess perceived knowledge on selected epidemiologic and statistical concepts/parameters and two problem based questions which tested the ability to apply knowledge were used. Data were analyzed calculating the proportion who perceived to have good knowledge regarding each concept. Logistic regression was applied to test for differences in good knowledge between different groups of subjects. RESULTS: More than 75% of the respondents claimed to have good knowledge on prevalence, sensitivity, specificity and case control studies. Less than 50% of them had good knowledge on risk difference, number needed to treat, systematic reviews, meta-analysis, p-value and 95% confidence intervals. Male doctors had a significantly higher good knowledge than female doctors (p<0.001), and those who read medical journals regularly than those who did not (p<0.05). Specialists and PG trainees had a significantly higher good knowledge (p<0.001) than grade medical officers. Correct answers of the respondents to the two problem based questions were 25% (n=79) and 15.8% (n=50), respectively. CONCLUSION : Even though some doctors claimed to have a good knowledge with regard to selected epidemiologic and statistical concepts, their ability to apply their knowledge was poor.
Knowledge of non-communicable diseases and practices related to healthy lifestyles among adolescents, in state schools of a selected educational division in Sri Lanka
(BioMed Central, 2017) Gamage, A.U.; Jayawardana, P.L.
BACKGROUND: Behaviors established during the adolescence have life-long consequences to the onset of non-communicable diseases (NCDs) in later life. Therefore, it is essential to understand adolescents' knowledge and practices with the intention of developing preventive programs focusing on this age group. The objective of the study was to assess knowledge about selected NCDs, and lifestyle choices among school students aged 17-19 years in state schools of the Maharagama Educational Division, Sri Lanka. METHODS: A descriptive, cross-sectional study was conducted among students aged 17-19 years attending state schools in Maharagama Education Division. A total of 634 students were selected from 9 schools conducting Advance Level classes. Stratified sampling was done based on stream of study and the number needed from each stratum was decided according to probability proportionate to size which was followed by cluster sampling within the strata to select the classes included. Data were collected using a self-administered-questionnaire on socio-demographic characteristics and economic status; lifestyle-related practices; knowledge on Non-Communicable -Diseases. Logistic regression was used to assess the associations. RESULTS: Proportion students with good overall knowledge was 43%(n = 272). Forty-three percent (n = 275) consumed a healthy diet, and 20%(n = 129) engaged in adequate physical activity 3%(n = 18) of students were current smokers and 12%(n = 73) current alcohol users 12%(n = 73). Overall "good" knowledge about NCDs was associated with being a science stream student(OR = 3.3; 95%CI:2.1-5.2). Healthy diet was associated with female sex (OR = 2.1; 95%CI: 1.5-3.0), and adequate physical activity with male sex (OR = 2.1; 95% CI:1.4-3.2), non-science-stream (OR = 2.1; 95%CI:1.2-3.7) and upper socio economic status (OR = 2.0; 95%CI:1.3-3.0). Non-smoking was associated with overall good knowledge (OR = 4.1; 95%CI:1.2-13.7) and female sex (OR = 0;95%CI:1.5-infinity). Abstinence from alcohol was associated with being a female (OR = 6.9; 95%CI:3.4-13.9), and with mother and fathers' education level of > General-Certificate of Examinations Ordinary Level (GCE O/L) (OR = 2.9; 95%CI:1.1-8.4 and OR = 3.5; 95%CI:1.1-11.2 respectively). CONCLUSION: Knowledge about NCDs and healthy lifestyle-practices were poor among school students aged 17-19 years. Lack of knowledge about healthy and unhealthy behaviors highlights the importance of carrying out regular surveillance for NCD risk factors, and initiating programs for the prevention of NCDs amongst adolescents.
Psychological status and physical disabilities of permanently disabled Sri Lankan servicemen
(Scientific Communications International Ltd., 2004) Kasturiaratchi, S.K.; Jayawardana, P.L.
OBJECTIVE: To describe the physical disabilities and to determine the prevalence of psychological ill health among permanently disabled servicemen. PATIENTS AND METHODS: 430 disabled servicemen were selected by stratified sampling from the 8 regiments of the Sri Lanka army. A self-dministered questionnaire was used to collect personal data and details of physical disabilities. The General Health Questionnaire and Bradford Somatic Inventory were used to detect psychological distress and the presence of somatic symptoms, respectively. RESULTS: Thirty-four (8.3%) of the 408 servicemen included in the analysis had more than 1 injury, giving a total of 442 injuries. The two most common disabilities were limb amputation (49.7%) and nerve injury (27.5%). 201 servicemen (49.3%) had a positive General Health Questionnaire result and 119 (29.2%) had a positive Bradford Somatic Inventory result. Of the 119 servicemen positive for Bradford Somatic Inventory, 109 (91.6%) had a positive General Health Questionnaire result (odds ratio, 23.3; 95% confidence interval, 11.2-49.9). CONCLUSIONS: The findings of this study may be useful for the adoption of a holistic approach for rehabilitation of disabled servicemen, and they emphasise the need for early diagnosis and treatment of psychological distress. AUTHOR KEYWORDS: Disabled persons; Military personnel; Psychological; Stress. INDEX KEYWORDS: adolescent; adult; army; article; controlled study; demography; disease severity; distress syndrome; emotional stress; General Health Questionnaire; health status; human; limb amputation; major clinical study; male; mass screening; nerve injury; physical disability; prevalence; psychiatric diagnosis; Sri Lanka
Public health midwives’ perception on breast cancer early detection services provided through well woman clinics in the Gampaha District, Sri Lanka
(College of the Community Physicians of Sri Lanka, 2013) Vithana, P.V.S.C.; Hemachandra, D.K.N.N.; Ariyarathne, M.A.Y.; Jayawardana, P.L.
INTRODUCTION: Being most common cancer diagnosed in Sri Lanka, breast cancer accounts for 27% of female cancer-mortality. Early-detection of breast cancer is conducted using clinical breast examination (CBE) and increasing awareness on breast self-examination through well woman clinics (WWCs). OBJECTIVE: To identify Public health midwives' (PHMs') perception on the importance and deficiencies of the breast cancer early-detection services provided through WWCs, and their suggestions on improving the breast cancer early-detection services. METHODS: A qualitative study using four focus group discussions (FGDs) consisting of 8-10 participants per each FGD were conducted among 38 PHMs in the Gampaha District during July to September 2008. FGD guide included discussion points on availability of guidelines and protocols, training received, time for clinic-sessions, adequacy of resources, support from other sectors, and reasons for low-participation and their recommendations for improving utilization of services. Two experts conducted FGDs as moderator and data recorder. FGDs were audio-recorded, transcribed and analyzed using constant comparison and identifying themes and categories. Results were presented in narrative form. RESULTS: All the PHMs had a firm realization on the need of breast cancer early-detection. FGDs revealed non-availability of guidelines, lack of training, lack of skills and material to provide health education, inability to provide privacy during CBE, shortage of stationery and lack of community awareness and motivation. The suggestions for the improvements identified in FGDs were capacity building of PHMs, making availability of guidelines, rescheduling clinics, improving the supervision, strengthening the monitoring, improving coordination between clinical and preventive sectors, and improving community awareness. CONCLUSIONS AND RECOMMENDATIONS: The components to be improved in breast cancer early-detection services were identified. Study recommends training programmes at basic and post basic levels on a regular basis and supervision for the sustenance of the program.
Retinoblastoma patients treated in Sri Lanka from 2014 to 2020: epidemiology, clinical status and correlates of lag time in seeking tertiary care services
(BioMed Central, 2024) Kugalingam, N.; De Silva, D.; Abeysekera, H.; Nanayakkara, S.; Tirimanne, S.; Chandrasekharan, V.; Jayawardana, P.L.
BACKGROUND Retinoblastoma (RB) is a tumour of children < 5 years with a incidence of 1 in 20,000. Around 20 RB cases are diagnosed yearly in Sri Lanka, a lower middle-income country with high literacy levels and healthcare free at point of delivery. Incidence, local and systemic severity and mortality related to RB are reportedly high in low- and middle- income countries in comparison to higher income countries. Aims of this study were to describe demographic, socioeconomic, and clinical characteristics of Sri Lankan RB patients attending the designated RB unit at the Lady Ridgeway Hospital (LRH), Colombo between January 2014 to December 2020, and determine correlates of lag time (LT) for first tertiary care visit after detecting the first symptom/sign.METHODS Two descriptive cross-sectional studies (DCSS) were conducted, one on 171 RB patients with demographic and clinical data collected between 2017 and 2020. In 2021, the second DCSS took place where socioeconomic and further demographic data were collected using telephone interviews, recruiting a subgroup of 90 (53%), consenting and contactable RB patient/ parent pairs. Bivariate and multivariable analyses were applied to determine correlates of LT of > 4 weeks for first tertiary care visit. Results were expressed as odds ratios and 95% confidence intervals.RESULTS LRH survey (N = 171): Median age at diagnosis was 15 months (range 1-94 months; IQR: 8-27); 89 (52%) were females. Groups D and E tumours were 25.7% (n = 44) and 62.6% (n = 107) respectively with 121 (71%) enucleations. The number of deaths were 2 (1.2%). Telephone survey (N = 90): Proportion with LT of > 4 weeks for first tertiary care visit was 58% (n = 52). None of the putative risk factors (ethnicity, parental educational level, socioeconomic status, distance from residence to tertiary care unit and receiving financial assistance) were associated with LT in both analyses.CONCLUSION Despite a high proportion with groups D and E tumours and enucleations, mortality rate was low, most likely due to availability of designated tertiary care. No correlates for LT of > 4 weeks for tertiary care presentation were identified. Early RB detection needs rigorous implementation of screening strategies and increased awareness among primary care health workers and parents.
Risk factors for delivering a small for gestational age infant
(Sri Lanka College of Obstetricians and Gynaecologists, 2004) Abeysena, C.; Jayawardana, P.L.; Seneviratne, S.R.A.
OBJECTIVE: To determine the risk factors for delivering a small for gestatJonal age (SGA) infant. METHODOLOGY: A prospective study was carried out at two MOH areas in the Gampaha district, during the period of May 2001 to April 2002. Eight hundred and twenty pregnant mothers were recruited at £16 weeks of gestation and followed up until partus. Demographic, socloeconomic and obstetric data of the mothers were gathered at the time of recruitment. Trimester specific exposure statuses along with potential confounding factors were gathered on average at the 12 , 28 and 36 weeks of gestation. Physical activities were assessed by asking the duration of specific postures adopted per day by the mothers during each trimester at home for house wives and both at home and during working hours for those who were engaged in paid employment. Shift work and work related physical and chemical exposures were also assessed. Psychosocial stress was ascertained using the Modified Life Events Inventory and the General Health QuestionnaireJJO. Ultrasound scan was performed to determine the gestationai age based on foetal biparietal diameter. SGA was assessed using customized growth centile charts developed by Gardosi et al. Univariate and multivariate logistic regression analysis (sample size=504) were applied and the results are expressed in odds ratios (OR) and 95% confidence intervals (95%CI) with the probability levels (P). RESULTS: When cut off for SGA was considered as <10 centile of the customized birth weight centiles, the proportion of SGA was 16.4%. Although the univariate analysis revealed that sleeping for < 8 hours during 2" or 3 or both trimesters (OR=1.645 95% CI= 1.00-2.67; P=0.04) and work related exposures during 2 or 3 or both trimesters (OR=2.42,95% GUI.19-4.93; P=0.01) were significantly associated with SGA, none of these factors became significant on multivariate logistic regression analysis. When the cut off was considered as <5 centile of the customised birth weight centiles, the proportion of SGA was 8.8%. Sleeping <8 hours during 2 or 3 or both trimesters (OR=2.34,95% CI=1.18-4.61; P=0.01), work related exposures during 2" or 3' or both trimesters (OR=2.91, 95% CM.27-6.65; P=0.01) and alcohol consumption during the 3' trimester {OR=4.33, 95% CI=1.11-16.94; P=0.03) had statistically significant association with SGA in the univariate analysis. Multivariate logistic regression also revealed that sleeping for <8 hours during 2" or 3 or both trimesters (OR=2.14, 95% 01=1.06-4.32; P=0.03), and walking for < 2.5 hours per day (OR=2.40> 95% CM.05-5-51; P=0.04) and alcohol consumption during the 3' trimester (OR=8.01,95% CM.31-49.02; P=0.02) were risk factors. CONCLUSIONS: Risk factors for being SGA when SGA is defined as <5 centile of the customised birth weight centiles are, sleeping for <8 hours during 2 or 3 or both trimesters, walking < 2.5 hours per day and alcohol consumption during 3 trimester. It is recommended that the importance of sleeping >8 hours and walking > 2.5 hours per day and avoidance of alcohol be emphasised to pregnant mothers.
Risk factors for low resilience among grade 10 adolescents in the Gampaha District
(Sri Lanka Medical Association, 2023) Manori, D.M.S.; Jayawardana, P.L.; Godamunne, P.
INTRODUCTION: Resilience denotes the ability to withstand adversity and bounce back from difficult life events. OBJECTIVE: To determine risk factors for low resilience among Grade 10 adolescents in the District of Gampaha. METHODS: A case-control study with a computed sample size of 128 in each among cases (low resilience) and controls (high resilience) was conducted. Cases and controls were selected by applying simple random sampling to a descriptive study where the magnitude of resilience was determined. For data analysis bivariate (using chi-square test) followed by multiple logistic regression were applied. Results were expressed as adjusted odds ratios with 95% confidence intervals. RESULTS: Risk factors for low resilience were: one or both parents dead (AOR=3.4; 95% CI [1.1, 10.1]; p=0.031), mother’s educational level ≤GCE A/L (AOR=2.3; 95% CI [1.4, 3.6]; p=0.001), losing temper frequently (AOR=2.5; 95% CI [1.9, 3.4]; p<0.001), having <6 friends (AOR=1.4; 95% CI [1.03;1.9]; p<0.048), having <6 close friends (AOR=1.6; 95% CI [1.06, 2.5]; p=0.024), having conflicts with friends (AOR=2.0; 95% CI [1.03, 3.74]; p=0.040), lack of support from home (AOR=1.5; 95% CI [1.04, 2.20]; p=0.031), not seeking help when facing difficult situations (AOR=1.7; 95% CI [1.2, 2.3]; p=0.001), sleeping for <8 hours/day (AOR=1.4; 95% CI [1.2, 1.8]; p=0.007), lack of religious affiliations (AOR=2.6; 95% CI [1.2, 5.7]; p < 0.015) and non-attending Sunday school (AOR=2.1; 95% CI [1.5, 3.2]; p<0.001). CONCLUSION: Eleven risk factors were identified. Recommend conducting cognitive behavioural therapy-based interventions regularly at the school level targeting to minimize the impact of the above risk factors.
Stemming TB: the Sri Lankan experience
(2007) Jayawardana, P.L.; Sarukkali, C.; Wickremasinghe, A.R.
No Abstract Available
Validity of the Sinhala version of the general health questionnaires item 12 and 30: Using different sampling strategies and scoring methods
(Ibn Sina Academy of Medieval Medicine & Sciences, 2016) Abeysena, H.T.C.S.; Jayawardana, P.L.; Peiris, M.U.P.K.; Rodrigo, A.
OBJECTIVE: To determine the criterion validity of the Sinhala version of the General Health Questionnaire-12 (GHQ-12) and GHQ-30 employing different sampling designs and scoring methods. METHODS: This was a descriptive cross-sectional study including 374 patients. The GHQ-30 was completed by the participants using likert scale and then converted into standard score. The ‘Clinical Examination’ was done blindly to the GHQ score as the reference standard. Total study sample was considered as a representative sample taken consecutively. Case-reference design included 126 cases and 126 randomly selected controls based on reference standard. Test result-based designs included two groups of positive and negative GHQ, based on the optimal cut-off level. Cut-off levels were determined by using three criteria. In addition stratum specific likelihood (SSLR) ratio also considered. RESULTS: Applying consecutive sampling design, for the GHQ-12, the optimal cut-off levels were 9/10 using likert score and 2/3 using standard score and for the GHQ-30, 25/26 using likert score and 6/7 using standard score. The optimal cut-off level depends on the different sampling designs employed in addition to criteria for determining cut-off levels. The SSLR of>1 was useful for determining optimal cut-off level. Irrespective of the scoring methods, application of case-reference design tends to be overestimation of the specificity with high threshold values and test result-based design tends to be overestimation of the sensitivity, compared to consecutive sampling. Using likert scoring method, the sensitivities were higher than standard scoring method. CONCLUSIONS: The optimal cut-off levels depend on the sampling design and the scoring method employed and criteria to determine cut-off levels.
Ventilatory function in brass workers of Gadaladeniya Sri Lanka
(Oxford University Press, 1997) Jayawardana, P.L.; de Alwis, W.R.; Fernando, M.A.
A cross sectional study was conducted to determine the respiratory hazards of brass workers. The study group was selected randomly. The control group was selected from the general population matched for age by cluster sampling. There was a total of 154 pairs for the final analysis. A questionnaire was administered to determine the prevalence of respiratory symptoms. Forced vital capacity (FVC), forced expiratory volume in the first second (FEV1.0), forced expiratory flow rate in the mid 50% of the FVC(FEF25%-75%) and peak expiratory flow rate(PEFR) were measured. Chest radiography was performed on those with 5 or more years of service. Cough, phlegm, chronic bronchitis and dyspnoea were significantly higher among brass workers. The ventilatory capacity was significantly lower in all the indicators except FVC. Smoking had no significant effect and a dose response relationship could not be demonstrated after inclusion of age in the regression model. Five point five per cent had evidence of septal lines while 6.4% had emphysema.