Browsing by Author "Senarathna, B.P."
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Item Prevalence of enterobiasis among primary school children in Ragama MOH region(Sri Lanka College of Microbiologists, 2012) Gunawardena, N.K.; Chandrasena, T.G.A.N.; Senarathna, B.P.; Silva, G.M.K.S.; de Silva, N.R.INTRODUCTION: Although frequently diagnosed clinically, there is only one previously reported survey of Enterobius vermicularis infection among Sri Lankan children, conducted in the 1980s. OBJECTIVES: To determine the prevalence of enterobiasis among Year One school children in Ragama MOH area and investigate association between infection and risk factors. METHOD: A cross sectional descriptive study was performed among Year One children in seven randomly selected schools. Infection was diagnosed using adhesive cellophane peri-anal swabs obtained on two consecutive days. A pre-tested, self-administered questionnaire completed by the mother, identified risk factors associated with enterobiasis. Initial univariate analysis was followed by multivariate analysis with logistic regression. RESULTS: Of 322 children, 276 (male: female ratio 1.1:1, mean age 6 years) returned the swabs and questionnaires (compliance 85.7%). Prevalence of infection by double and single swab examination was 37.5% and 20.1% respectively. Prevalence was significantly lower among children of more educated mothers (34.2%), fathers with permanent employment (28.9%) and those dewormed in the last 30 days (22%) compared to children of less educated mothers (46.5%), fathers with casual (46.9%) or no employment (36.4%) and those not dewormed recently (41.6%)(P<0.05). Infected children belonged to households with significantly more members, siblings and persons sleeping with index child (P<0.05). Multivariate analysis showed that more children in a household and recent deworrning were the only significant determinants of enterobiasis. CONCLUSIONS: Over one-third of primary school children in the Ragama MOH area have enterobiasis. The risk of infection is higher in families with more children and is reduced by regular deworrning.Item Randomized placebo-controlled trial of the efficacy of mebendazole polymorphs in the treatment of hookworm infections(Sri Lanka College of Microbiologists, 2013) Gunawardena, N.K.; Kumarendran, B.; Manamperi, N.H.; Senarathna, B.P.; Silva, M.; Pathmeswaran, A.; de Silva, N.R.INTRODUCTION: Mebendazole has three polymorphic forms, identified as A, B and C. Animal studies and one previous study in humans have suggested that unlike polymorph C, polymorph A is ineffective in the treatment of hookworm and whipworm infections. OBJECTIVES: A randomized double-blind, placebo-controlled trial was carried out to compare the efficacy of single dose 500 mg tablets of pure mebendazole polymorph C with those containing a 1:1 mixture of polymorphs Aand C, for the treatment of hookworm infections. . DESIGN, SETTING AND METHODS: All eligible individuals living in 219 households in 8 estate divisions in Ratnapura District known to have a high prevalence of hookworm, were recruited after obtaining written, informed consent. A single faecal sample was obtained and examined the same day, using the Kato-Katz technique for quantification of intestinal nematode infections. Those who were found infected with hook¬worms were randomized to one of three treatment arms and requested to provide a second faecal sample 10-14 days after treatment. This was examined in the same manner as the first. RESULTS: A total of 892 individuals were recruited; 601 provided faecal samples; 214 were found positive for hookworm infection; 70, 74 and 70 individuals were randomized to treatment arms A (mixture of polymorphs A and C), B (pure polymorph C) and C (placebo) respectively. Follow-up faeca! samples were provided by 53,48 and 49 persons respectively in each treatment arm. The cure rates in the three treatment arms were 28.3%, 18.8% and 16.3% respectively; they were not significantly different from one another. Comparison of faecal egg count reductions (FECR) in the 3 treatment arms (86.1%, 84.5% and -6.6% in arms A, B and C respectively) showed that both mebendazole formulations performed significantly better than placebo, but there was no statistically significant difference between FECR with the two drug formulations. CONCLUSIONS: A single SOOmg dose of mebendazole, either as Polymorph C alone, or as a mixture of Polymorphs A and C, has little efficacy in curing hookworm infections. However, both formulations are significantly better than placebo in reducing the intensity of infection, with no statistically significant difference between the two formulations.Item Randomized placebo-controlled trial of the efficacy of mebendazole polymorphs in the treatment of hookworm infections(American Society of Tropical Medicine and Hygiene, 2013) Gunawardena, N.K.; Kumarendran, B.; Manamperi, N.H.; Senarathna, B.P.; Silva, M.; Pathmeswaran, A.; de Silva, N.R.Mebendazole has three polymorphic forms, identified as A, B and C. It has been suggested that unlike polymorph C, A is ineffective in the treatment of hookworm and whipworm infections. A randomized doubleblind, placebo-controlled trial was carried out to compare the efficacy of single dose 500 mg tablets of pure mebendazole Polymorph C with those containing a 1:1 mixture of Polymorphs A and C, for the treatment of hookworm infections. All eligible individuals living in 219 households were recruited after obtaining written, informed consent. A single fecal sample was obtained and examined the same day, using the Kato-Katz technique for intestinal nematode infections. Those who were found infected with hookworms were randomized to one of three treatment arms and requested to provide a second faecal sample 10 - 14 days after treatment. This was examined in the same manner as the first. A total of 892 individuals were recruited; 601 provided fecal samples; 214 were found positive for hookworm; 70, 74 and 70 individuals were randomized to treatment arms A (mixture of polymorphs A and C), B (pure polymorph C) and C (placebo) respectively. Follow-up samples were provided by 53, 48 and 49 persons respectively in each treatment arm. The cure rates in the three treatment arms were 28.3%, 18.8% and 16.3% respectively; they were not significantly different from one another. Comparison of fecal egg count reductions (FECR) in the 3 treatment arms (86.1%, 84.5% and -6.6% in Arms A, B and C respectively) showed that both mebendazole formulations performed significantly better than placebo, but there was no statistically significant difference between FECR with the two drug formulations. It is concluded that a single 500mg dose of mebendazole, either as Polymorph C alone, or as a mixture of Polymorphs A and C, has little efficacy in curing hookworm infections. However, both formulations were significantly better than placebo in reducing the intensity of infection, with no statistically significant difference between the two formulations.