Browsing by Author "Premasiri, D.A."

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Clinical diagnosis of uncomplicated malaria in Sri Lanka
(SEAMEO Regional Tropical Medicine and Public Health Project, 1998) van der Hoek, W.; Premasiri, D.A.; Wickremasinghe, A.R.
To assess the possibility of developing a protocol for the clinical diagnosis of malaria, a study was done at the regional laboratory of the Anti-Malaria Campaign in Puttalam, Sri Lanka. Of a group of 502 patients, who suspected they were suffering from malaria, 97 had a positive blood film for malaria parasites (71 Plasmodium vivax and 26 P. falciparum). There were no important differences in signs and symptoms between those with positive and those with negative blood films. It is argued that it is unlikely that health workers can improve on the diagnosis of malaria made by the patients themselves, if laboratory facilities are not available. For Sri Lanka the best option is to expand the number of facilities where microscopic examination for malaria parasites can take place.
Early diagnosis and treatment of malaria in a refugee population in Sri Lanka
(SEAMEO Regional Tropical Medicine and Public Health Project, 1997) van der Hoek, W.; Premasiri, D.A.; Wickremasinghe, A.R.
To provide early diagnosis and prompt treatment for malaria, two interventions were compared in refugee camps in Kalpitiya, Sri Lanka. Community health volunteers (HV's) were trained in diagnosis and management of malaria on clinical grounds, while a field laboratory was established in another group of camps providing treatment after laboratory confirmation of a malarial infection. Patients with fever sought treatment from HV's on average after 2.74 days and from the field laboratory after 3.20 days. Although acceptance of both interventions was high, the effective catchment areas, especially of the HV's were small. Large numbers of health volunteers would be needed to cover all families, making it difficult to sustain supervision and necessary logistic support. For every malaria patient treated by HV's, three others would receive anti-malarial drugs unnecessarily. The maintenance of a field laboratory with a microscopist of the Anti-Malaria Campaign is not an economically viable option. Training of HV's in microscopy with a mechanism for cost recovery should be given serious consideration. HV's and diagnosis and treatment centers should be able to handle a wide spectrum of common diseases. A better option for Sri Lanka in the short term might be to improve existing general health facilities that are accessible to the refugee population
Malarial vectors in an irrigated rice cultivation area in southern Sri Lanka
(Oxford University Press, 2005) Premasiri, D.A.; Wickremasinghe, A.R.; Premasiri, D.S.; Karunaweera, N.
Entomological surveys were carried out from March 1998 to December 1999 to study the prevalence, distribution and abundance of malarial vectors in relation to selected environmental factors and potential mosquito breeding sites in irrigation channels in 15 villages in the Lunugamvehera Irrigation and Settlement Project, a malaria-endemic area of southern Sri Lanka. Mosquito collections were made at monthly intervals using four sampling methods. Thirteen anopheline species were collected. Following monsoonal rains, anopheline breeding took place primarily in rainwater accumulations. During the inter-monsoonal period, pools formed in the irrigation system, semi-permanent pools formed as a result of rainfall and permanent ground pools were the major breeding sites of anophelines. Very little anopheline breeding took place within the irrigation channels. Amongst the seven anopheline species collected from human dwellings, Anopheles subpictus was the most prevalent, followed by A. culicifacies; together these two species comprised more than 99% of the indoor resting population. The number of days of rain was an important macro-epidemiological factor influencing the density of malarial vectors. There was no consistent trend between the amount of water released or the number of days of water release from the reservoir and the outdoor or indoor resting densities of anophelines.