Browsing by Author "Liyanage, C."

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An ABO-incompatible living donor liver transplant in an infant with acute liver failure in the Sri Lankan setting
(The Sri Lanka Medical Association, 2023) Fernando, M.; Tillakaratne, S.; Gunetilleke, B.; Liyanage, C.; Appuhamy, C.; Weerasuriya, A.; Dissanayake, J.; Siriwardana, R.
Liver transplant (LT) is the standard therapy for medically refractory acute liver failure (ALF). Finding a deceaseddonor graft in an emergency is challenging and often overcome by living-donation. Blood group matching is practised for LT though ABO-incompatible liver transplant (ABOi-LT) is performed inselected circumstances. We report an infant who underwent successful ABOincompatible living donor LT for ALF of unknown aetiology. This being the country’s first ABOi-LT, the youngest LT recipient to date and the youngest receiving emergency LT for ALF; we describe the novel experience at a resource-limited setting in Sri Lanka (SL).
Challenges faced in establishing a pediatric liver transplant program in a lower‐middle‐income country with free healthcare service
(Wiley, 2024) Fernando, M.; Tillakaratne, S.; Gunetilleke, B.; Liyanage, C.; Appuhamy, C.; Weerasuriya, A.; Uragoda, B.; Welikala, N.; Ranaweera, L.; Ganewatte, E.; Dissanayake, J.; Mudalige, A.; Siriwardana, R.
ABSTRACT: BACKGROUND: Liver transplant is the cure for children with liver failure. Sri Lanka is a lower-middle-income country with a predominant free, state health system. Pediatric liver transplant program in Sri Lanka is still in the budding state where the initial experience of the program is yet to be documented. METHODS: A retrospective review was performed including the clinical characteristics of all pediatric liver transplant recipients of Colombo North Centre for Liver Diseases since the inception of the program from June 2020 to May 2023. RESULTS: There were 14 PLT performed in 3 years. The median recipient age and weight were 8 years (6 months–15 years) and 23.3 kg (6.4–49.2), respectively. The majority were boys (64%). All were from low-income backgrounds. Indications for LT were acute liver failure (5/14), decompensated chronic liver disease (5/14), and acute on chronic liver failure (4/14). Underlying liver diseases were Wilson disease (6/14), autoimmune liver disease (3/14), biliary atresia (2/14) and progressive familial intrahepatic cholestasis type 3 (1/14), and unknown etiology (2/14). The majority were living donor liver transplants (86%). Of the living donors, 42% (5/12) were Buddhist priests. There were three immediate deaths and two late deaths. The 3-month survival was 78%, and overall survival was 64%. Living donor transplants carried a higher success rate (92%) compared to diseased donor transplants (0%; 2/2). CONCLUSIONS: Initial experience of pediatric liver transplant program of Sri Lanka is promising despite being established in a free healthcare system amidst the crisis circumstances.
Clinical characteristics and outcome of hepatocellular carcinoma in alcohol related and cryptogenic cirrhosis:a prospective study
(Elsevier, 2015) Siriwardana, R.C.; Niriella, M.A.; Dassanayake, A.S.; Liyanage, C.; Gunetilleke, B.; Jayathunge, S.; de Silva, H.J.
BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is becoming a leading cause of chronic liver disease. Hepatocellular carcinoma (HCC) is one of its complications. Although the pathophysiology is unclear, it is reasonable to expect that cryptogenic cirrhosis related HCC (cryptogenic HCC) behaves differently to other types of HCC. This study prospectively compared patients with cryptogenic HCC and those with HCC related to alcoholic cirrhosis. METHODS: A total of 150 consecutive patients with HCC (89 cryptogenic HCC and 61 alcohol related HCC) referred to our unit over a 23-month period were studied. Their demographic data, liver function, tumor characteristics and outcomes were compared. RESULTS: Alcohol related HCC was seen only in males. Compared with cryptogenic HCC, alcohol related HCC had significantly higher aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio (1.7 vs 1.4, P=0.002), model for end-stage liver disease score (13 vs 11, P=0.018) and Child's score (7 vs 6, P=0.037). No significant difference was seen in platelet counts, serum sodium and AST to platelet ratio index. Single nodular tumors were more common in cryptogenic HCC, while diffuse type tumors and macroscopic vascular invasion were common in alcohol related HCC. In patients who could not be offered any treatment because of advanced tumors or poor liver function, alcohol related HCC had a significantly lower median survival (5.3 months) compared with cryptogenic HCC (9.3 months, P=0.034). CONCLUSIONS: Compared with cryptogenic HCC, alcohol related HCC had worse liver function and aggressive tumor morphology at presentation, and a higher proportion was untreatable. In patients who could not be treated, median survival was lower in patients with alcohol related HCC than in those with cryptogenic HCC.
Comparison of performance of Sri Lankan and US children on cognitive and motor scales of the Bayley scales of infant development
(Biomed Central, 2014) Godamunne, P.; Liyanage, C.; Wimaladharmasooriya, N.; Pathmeswaran, A.; Wickremasinghe, A.R.; Patterson, C.; Sathiakumar, N.
BACKGROUND: There is no validated scale to assess neurodevelopment of infants and children in Sri Lanka. The Bayley III scales have used widely globally but it has not been validated for Sri Lankan children. We administered the Cognitive and Motor Scales of the Bayley III to 150 full-term children aged 6, 12 and 24 months from the Gampaha District of Sri Lanka. We compared the performance of Sri Lankan children 6, 12 and 24 months of age on the cognitive and motor scales of the Bayley III with that of US children. RESULTS: Compared to the US norms, at 12 months, Sri Lankan children had significantly higher cognitive scores and lower gross motor scores, and at 24 months significantly lower cognitive scores. The test had a high test-retest reliability among Sri Lankan children. CONCLUSIONS: There were small differences in the cognitive and motors scores between Sri Lankan and US children. It is feasible to use Bayley III scales to assess neurodevelopment of Sri Lankan children. However, we recommend that the tool be validated using a larger representative sample of all population groups.
Developing a Dependency Tag Set for Sinhala: Procedure and Issues.
(The Third International Conference on Linguistics in Sri Lanka, ICLSL 2017. Department of Linguistics, University of Kelaniya, Sri Lanka., 2017) Liyanage, C.; Wijeratne, W.M.
Dependency Grammar (DG) is considered as one of the prominent theories of syntax. In order to analyze a particular language on DG and to make an annotated Dependency Treebank, a Tag set is needed. The objective of this research is to compile a Dependency Treebank for Sinhala. As part of compiling, the Treebank a Tagset was developed. This study is designed to explore the procedure and issues of developing a dependency tagset, with special focus to Sinhala Language. Methodology of the study includes 1. Identify same grammatical categories from benchmark tagsets 2. Find out syntactico-semantic categories from traditional Sinhala grammar books 3. Analyze sentences extracted from UCSC Sinhala corpus and further identify grammatical categories 4. Verify the tagset. In literature no reported work has been done based on DG for Sinhala. However, syntactic analysis on other grammatical traditions, Sinhala grammar books and several tagsets were referred in this work. Among the referred tag sets, Stanford typed dependencies manual (Marneffe and Manning, 2016) and AnnCorra: TreeBanks for Indian Languages-Guidelines for Annotating Hindi TreeBank (Bharati et al, 2012) were selected as benchmark tagsets. To ensure uniformity of the tagsets many tags for the same grammatical categories were taken from the above benchmark tag schemas. Findings of the research introduce syntactico-semantic categories and levels of dependency relations of words in Sinhala. The tagset comprises 42 tags and can be used in related works on DG for Sinhala.
Duodenal diverticuli: do they predispose for Common Bile Duct (CBD) pathology?
(The College of Surgeons of Sri Lanka, 2012) Liyanage, C.; Keragala, T.; Femandopulle, N.; Nawaratne, N. M. M.
INTRODUCTION: Periampullary duodenal diverticuli (PDD) are extra luminal mucosal out pouching of duodenum arising adjacent to or containing the ampulla of Vater or intraluminal portion of CBD . Juxta-papillary duodenal diverticuli (JPDD) are defined as diverticuli located with in radius of 2 cm of major papilla but not involving them. We note that patients with 'DD have a higher tendency for stone formation and biliary complications. METHODS: 100 consecutive patients who underwent ERCP at the National Hospital Sri lanka in 2011 were included in this study. The incidence of DD, position , associated pathology ,difficulty index, special procedures, outcome and complications were noted. RESULTS: 26 patients had DD. 18 had PDD and 6 JPDD. 12/18 of PDD and 4/6 JPDD had common bile duct stones. 1/26 an ERCP could not be. performed and had open CBD exploration. In 6/18 with PDD a hurricane balloon dilatation of the papilla was done instead of sphincterotomy. There · was one hilarcholangio cancer and 2 pancreatic cancers and 4 pancreatitis patients. Patients with stone disease were managed with total endoscopic procedures in 23/24. CONCLUSIONS: Patients with PDD and JPDD have a high incidence of CBD stones disease. .A papillary manometry study could be undertaken to ascertain the biliary sphincter pressures in patients with PDD.
The Effectiveness of Microfinance Services on Poverty Alleviation: Comparative Analysis of Anuradhapura District and Colombo District in Sri Lanka
(Department of Finance, University of Kelaniya, 2023) Kannangara, N.; Liyanage, C.
Purpose: The purpose of the study is to determine the effectiveness of microfinance services on household income to alleviate poverty in both rural and urban areas of Sri Lanka, and which area has successfully used microfinance services to alleviate poverty. Design/Methodology/Approach: The researcher chose Anuradhapura as the rural area and Colombo as the urban area to conduct the study. In this regard, data was collected from 280 microfinance beneficiaries in the Anuradhapura and Colombo districts using a survey questionnaire. Microfinance services such as micro-credit and micro-entrepreneurship training were employed as the independent variables in this study, with poverty alleviation as the dependent variable. Simple random sampling was used to collect the data then were analyzed using SPSS software. Findings: According to the study's findings, both entrepreneurship training and micro-credit have a statistically significant positive relationship with poverty alleviation in both districts. According to the regression results, entrepreneurship training is more effective in reducing poverty in the Colombo district, but microcredit is more beneficial in the Anuradhapura area. Conclusion: The findings highlighted that microfinance services are more effective in alleviating poverty in urban and rural areas of Sri Lanka. Further, micro-credit services were more effective in urban (Colombo) areas than in rural (Anuradhapura) areas in Sri Lanka. However, the micro-entrepreneurship trainings were more effective in rural areas than in urban areas in Sri Lanka. Therefore, the researcher suggests that microfinance services should be promoted to alleviate poverty in Sri Lanka while more micro-credit services to urban areas and more micro-entrepreneurship training to rural areas.
The Efficacy of micronutrient supplementation in reducing the prevalence of anaemia and deficiencies of zinc and iron among adolescents in Sri Lanka
(Nature Publishing Group, 2008) Hettiarachchi, M.; Liyanage, C.; Wickremasinghe, R.; Hilmers, D.C.; Abrams, S.A.
Fifty liver transplants: a single centre experience of haemodynamic management in liver transplantation for cirrhosis [part 1]
(College of Surgeons of Sri Lanka, 2021) Gunetilleke, B.; Ranamuni, R.; Jayaweera, D.; Welikala, N.; Kerner, V.; Munasinghe, N.; Withanage, R.; Wickremasinghe, N.; Hewage, S.; Wijesuriya, N.; Rodrigo, U.; Mudalige, A.; Fernando, M.; Hettiarachchi, D.; Dissanayake, J.; Niriella, M.; Dassanayake, A.; Thilakaratne, S.; de Silva, J.; Siriwardana, R.; WIjesuriya, R.; Liyanage, C.
ABSTRACT: Cirrhosis with end stage liver disease (ESLD) is a leading cause of non-communicable disease related deaths in Sri Lanka. Liver transplantation is the only curative treatment for patients with ESLD. The complex multisystem involvement and unique cardiovascular profile characteristic of ESLD present formidable challenges during liver transplantation. Management of the rapid and varied hemodynamic changes during surgery requires an in depth understanding of the physiological effects of each intervention. Based on the current literature and the experience gained at our center during the management of 50 liver transplants, we present optimization strategies and perioperative hemodynamic interventions which we use to ‘Fast track’ recovery following liver transplantation. KEYWORDS: Liver transplantation, cirrhosis, non-alcoholic fatty liver disease, alcohol related liver disease
Fifty liver transplants: a single centre experience of haemodynamic management in liver transplantation for cirrhosis [part 2]
(The College of Surgeons of Sri Lanka, 2021) Gunetilleke, B.; Ranamuni, R.; Jayaweera, D.; Welikala, N.; Kerner, V.; Hettiarachchi, D.; Munasinghe, N.; Withanage, R.; Wickremasinghe, N.; Hewage, S.; Fernando, M.; Hettiarachchi, D.; Niriella, M.; Dassanayake, A.; Thilakaratne, S.; Wijesuriya, R.; Liyanage, C.; Siriwardana, R.; Dissanayake, J.; Wijesuriya, N.; Rodrigo, U.; Rodrigo, U.; Mudalige, A.; de Silva, J.
Globally, an estimated one million deaths occur annually due to complications of cirrhosis. Cirrhosis with end stage liver disease [ESLD] is a leading cause death due to non- communicable diseases in Sri Lanka. Non-alcoholic fatty liver disease [NAFLD] and alcohol related liver disease [ARLD] are the principal causes of ESLD due to cirrhosis in Sri Lanka. Liver transplantation remains the only curative treatment for such patients. Multiorgan dysfunction and hemodynamic instability characteristic of ESLD adds to the complexity of perioperative care in liver transplantation. Maintenance of stable hemodynamics including optimal hemostasis forms the core of the anaesthetic strategy in liver transplantation.
Hilar cholangiocarcinomas - from nihilism to aggressive treatment
(The College of Surgeons of Sri Lanka, 2012) Liyanage, C.; Nawaratne, M.; Pathirana, A.; Gunasekara, D.; Pranahewa, L.; Prasad, R.; Wijeratne, T.; Bogammana, M.; Wijesooriya, R.; Siriwardhana, R.
INTRODUCTION: Hllar-Cholangio-carcinomas (HCC) are aggressive tumours with a dismal prognosis. The general tendency amongst all specialities is to palliate them. As response to adjuvant therapy is marginal we have embarked on aggressive management of these patients with the available surgical and endoscopic expertise. METHODS: Patients presenting to the North Colombo Teaching hospital· and the Gastrointerology unit of the National hospital in 2011 were included . All had Tri phasic CT , MRCP or ERCP prior to be discussed at MDT with all the above authors regarding further management. Patients with Bismuth 1 v lesions and unfit for surgery underwent Combination ERCP/doublestenting/RFA of lesion/Rendezvous procedure/Percutaneous, stenting or PTC. RESULTS: 32 patients were treated .5/32 had radical surgical resections (2 extended right hepatectomy with bile duct resecton and lymphadenectomy (BDR+LA), 2 extended left hepatectomy +BDR+LA, and 1 extended heft hepatectomy with BDR+LA+Reconstruction of Right hepatic artery and right portal vein. I underwent segment iii bypass. 7 patients underwent ERCP and serial RFA with stenting. 3/5 patients are alive and disease free at 6-12 months. CONCLUSIONS: Where possible HCC patients should be offered a curative resection. RFA gives longer and better palliation compared to standard stenting. These patients should be managed by a specialized team as aggressive management may improve their survival.
Impact of Financial Literacy Levels among Sri Lankan Investors on Investment Choices
(Department of Finance, University of Kelaniya., 2021) Tennekoon, S. T. M. S.; Liyanage, C.
Purpose: The purpose of this study is to investigate the level of financial literacy among Sri Lankan investors and its impact on investment choices. Design/methodology/approach: The population of this study consisted of the individual investors of Sri Lanka. Accordingly, a sample of 352 responses were obtained through a survey which was conducted using structured self-administered questionnaire. The independent variable of the research is financial literacy with the dependent variable being the investment choice. Multinomial logistic regression was used to test the hypothesis. Findings: The results of the study revealed that the majority of investors in Sri Lanka are having low objective and subjective financial literacy. Further, the results revealed that financial literacy has a statistically significant impact on the current and future choice of different investment products as the main source of investment. Originality: Financial literacy level of individual investors was assessed by using the mean value of the financial literacy score, which has not been commonly used in the Sri Lankan context. This study further contributed to the local body of literature by analyzing the investors’ current main and secondary holdings of seven different
Iron absorption from a traditio nal Sri Lankan weaning food and the enhancing effect of ascorbic acid in adult male volunteers
(Sri Lanka Medical Association, 1996) Liyanage, C.; Goonaratna, C.; Thabrew, I.
OBJECTIVE:To study absorption of iron from Centella gruel and the enhancing effect of ascorbic acid in young adult males.DESIGN: An in vivo absorption study. SETTING: Faculty of Medicine, Galle. METHODS: The percentage of iron absorbed from the Centella gruel was measured using a double isotope technique with 55Fe and 59Fe on 10 healthy male volunteers. OUTCOME MEASURE: Percentage of iron absorption from the gruel with and without ascorbic acid. RESULTS: The mean iron absorption from each meal of Centella gruel was 2.2% (SEM 0.8). This increased to 5% (SEM 1.6) by addition of 50 mg ascorbic acid. When ingested with ascorbic acid, the bioavailable nutrient density (BND) of the weaning food was increased from 0.23 to 0.53 mg iron/1,000 kcal. To satisfy the daily physiological requirements of iron in infants and toddlers, it was calculated that apart from ascorbic acid supplementation, the total iron content also needs to be increased from 2.05 mg to 4.0 mg/meal. CONCLUSION: Centella gruel cannot provide the amount of iron to meet the BND for iron required by infants and toddlers, unless supplemented with an enhancer of iron absorption such as ascorbic acid and its total iron content is increased.
Medicalization of Pregnancy and Childbirth in Sri Lanka
(University of Kelaniya, 2005) Liyanage, C.
Whether the pregnancy and childbirth is a normal event or only a biomedical condition, is yet to be resolved with clear-cut definitions. In the context of Sri Lanka, it had been totally managed by the lay people till the ultra modern science and technology assumed control. Till the gradual shifting of the deal to the hands of experts took place, the event of pregnancy and childbirth was engulfed by a whole network of relations, values, local beliefs and knowledge system. The magnanimity of the expert is such that by now it has become a medicalized issue even in the remote areas. The transfiguration of pregnancy and childbirth is not simply a metaphor for shifting from one institutional site (family and traditional birth attendant) to another (hospital), but also symbolized as a transition of knowledge system regarding the body in general and women’s reproductive body in particular. The objectives of this paper are to explore as to how the event of pregnancy and childbirth has become a medicalized issue even within the village space; how has the transition took place from a totally lay knowledge management to a medicalized issue and what will be the position of already existing and the heretofore knowledge of this subject as against the ensuing medicalize process. Empirical evidence of this study clearly reflects the lack of attention to the social and cultural factors which has not only led to the virtual extinction of the traditional knowledge system, but also to the modern system being deprived of an opportunity for a grand success by incorporating certain constructive traditional aspects.
Nasojejunal feeding versus feeding jejunostomy after upper gastrointestinal surgery
(College of Surgeons of Sri Lanka, 2014) Ranjithatharsini, M.; Deen, K.I.; Kumarage, S.; Liyanage, C.; Siriwardana, R.; Gunetilleke, B.
The use of enteral nutrition over parenteral nutrition is recommended in the case of patients undergoing major gastrointestinal surgery for cancer, as it reduces sepsis related morbidity. In this study we compared ourexperience of nasojejunal tube feeding with feeding jejunostomy
Nutrient intake and growth of adolescents in southern Sri Lanka
(Sri Lanka Medical Association, 2006) Hettiarachchi, M.; Liyanage, C.; Wickremasinghe, R.; Hilmers, D.; Abrams, S.A.
OBJECTIVE: Growth and dietary intake data are essential for formulation of nutritional policies and interventions for children. DESIGN: 945 school children (11-16 years) were subjected to growth assessment and their nutrient intake was determined using the 24-hour dietary recall method on three consecutive days. RESULTS: 21.3% of boys and 21.1% of girls were stunted (-2SD below the median height-for-age). 141 (14.9%) children were both stunted and wasted (-2 SD below the median weight-for-age). Mean body mass index of girls was significantly higher (p < 0.001) than boys at all ages. The mean daily dietary intake of energy was 3.2 (+/- 2.4) MJ, protein 29.1 (+/- 2.1) g, fat 4.5 (+/- 1.1) g, iron 11.5 (+/- 1.0) mg, and zinc 0.8 (+/- 0.7) mg among boys. Among girls, energy intake was 4.2 (+/- 1.8) MJ, protein 29.0 (+/- 2.3) g, fat 4.4 (+/- 1.0) g, iron 11.4 (+/- 1.0) mg, and zinc 0.5 (+/- 0.6) mg. Fat comprised about 4.0% of the daily energy intake. CONCLUSIONS: High rate of growth deficiency and under nutrition among adolescents mandates innovative nutritional intervention strategies. The observed mean intakes of nutrients in the sample showed a worrisome deviation from the recommendations of the dietary guidelines for Sri Lanka.
Obstructive jaundice caused by a biliary mucinous cystadenoma in a woman: a case report
(BioMed Central, 2013) Chandrasinghe, P.C.; Liyanage, C.; Deen, K.I.; Wijesuriya, S.R.E.
INTRODUCTION: Mucinous cystadenoma of the liver is a rare (less than 5%) neoplasm. This condition is more common in young women and accounts for non-specific symptoms. Cyst adenomas commonly affect the intrahepatic system (90%) and are rarely found in the extrahepaticbiliary system or affecting both the systems. CASE PRESENTATION: A 39-year-old Sinhalese woman presented with features of obstructive jaundice and was found to have a biliaryneoplasm on imaging. In the absence of a definitive diagnosis despite extensive imaging she underwent preoperative endoscopic biliarydrainage followed by a left hemihepatectomy with Roux-en-Y hepaticojejunostomy. A pathological examination of the specimen revealed an obstruction of the bile duct caused by a biliary mucinous cystadenoma affecting both the intrahepatic and extrahepatic systems. CONCLUSIONS: Biliary mucinous cystadenoma rarely present with obstructive jaundice affecting both intrahepatic and extrahepatic ducts. Exhaustive investigation might not help in the diagnosis and may need to be treated based on clinical judgment. The definitive treatment modality is surgery due to its malignant potential. The operative procedure is technically demanding and is best performed at specialist centers to minimize complications. © 2013 Chandrasinghe et al.; licensee BioMed Central Ltd.
On Step Away from the Quicksand of the New World: Michael Ondaatje’s Post-Colonial Haunting and Confused Migrant Identities in In the Skin of a Lion
(Faculty of Humanities, University of Kelaniya, Sri Lanka, 2011) Liyanage, C.
Optimizing intraoperative haemodynamics and haemostasis to enhance recovery after liver transplantation for cirrhosis in adults
(College of Anaesthesiologists of Sri Lanka, 2022) Gunetilleke, B.; Welikala, N.; Ranamuni, R.; Jayaweera, D.; de Silva, T.; Amerasinghe, O.; Liyanage, C.; Dissanayake, J.; Appuhamy, C.; Fernando, M.; Thilakarathne, S.; Dassanayake, A.; Niriella, M.; Siriwardana, R.; Gilbert-Kawai, E.
Cirrhosis with end stage liver disease is a leading cause of non-communicable disease related deaths in Sri Lanka. Liver transplantation remains the only curative treatment for such patients. Multi-organ dysfunction characteristic of end stage liver disease, surgical and anaesthetic factors, quality of the graft, coagulopathy and haemodynamic instability, all lead to the complexity of the perioperative care for liver transplant. Aggressive management focused particularly on maintaining intra-operative haemodynamic stability and optimizing haemostasis, directly impacts successful patient outcomes and forms the core of the anaesthetic strategy.
Prevalence and severity of micronutrient deficiency: a cross-sectional study among adolescents in Sri Lanka
(HEC Press, Australia, 2006) Hettiarachchi, M.; Liyanage, C.; Wickremasinghe, R.; Hilmers, D.C.; Abrams, S.A.
In order to determine the prevalence of micronutrient deficiencies (iron, zinc and folate) in Sri Lankan adolescent school children and the extent to which multiple micronutrient deficiencies exist in this population, a cross-sectional survey (2003) in the Galle district of the micronutrient and anthropometric status of 945 school children of ages 12-16 years was performed. The prevalence of anemia (Hb < 120.0 g/L) was 49.5% in males and 58.1% in females (overall 54.8%, gender difference, P = 0.004). In anemic children 30.2% of males and 47.8% of females were iron deficient (serum ferritin < 30.0 microg/L). Folate deficiency (<6.80 nmol/L) was found in 54.6% and 52.5% of boys and girls respectively whereas zinc deficiency(<9.95 micromol/L) occurred in 51.5% and 58.3%. Anemic boys had a 1.5 (95% confidence interval (CI) 0.9-2.6) and 1.6-fold (CI; 1.1-2.6) greater risk of being stunted and underweight, whereas the risk among anemic girls was 1.7 (CI; 1.1-2.7) and 1.0 (CI; 0.7-1.5) for being stunted and underweight. The relative risks of having at least two deficiencies in iron, zinc and folate among anemic children were 1.6 (CI; 0.6-4.2) among boys and 0.8 (CI; 0.5-1.5) among girls. Iron deficient subjects had a significantly increased risk of 1.8 (CI, 1.1-3.0) of being deficient in folate and 1.7 (CI, 1.2-2.6) of being deficient in zinc. Zinc deficient subjects had a risk of 1.3 (CI, 1.0-1.8) being iron deficient and 1.2 (CI, 0.9-1.7) of being folate deficient. Multiple micronutrient deficiencies are prevalent in Sri Lankan adolescents.