Browsing by Author "Wijesinghe, R.S."

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Efficacy of a limb-care regime in preventing acute adenolymphangitis in patients with lymphoedema caused by bancroftian filariasis, in Colombo, Sri Lanka
(Academic Press, 2007) Wijesinghe, R.S.; Wickremasinghe, A.R.; Ekanayake, S.; Perera, M.S.
The efficacy of a programme of community home-based care (CHBC) for lymphoedematous limbs was evaluated among 163 lymphoedema patientsattending two filariasis clinics in Colombo. Each patient was interviewed and examined and his or her lymphoedema was graded during a baseline assessment, before the CHBC programme, and again, during a post-intervention assessment, after the patient had been in the programme for 1 year. The number of patients having entry lesions was 24% lower at the post-intervention assessment than at the baseline (P<0.001), with a reduction in the frequency of each type of entry lesion investigated. In the year the patients were in the CHBC programme, 30% fewer of them experienced at least one attack of adenolymphangitis (ADL; P<0.001), the mean number of ADL attacks/patient was lower (P<0.001), and the mean duration of each ADL attack suffered was slightly shorter (5.70 v. 5.84 days; P>0.05) than in the year before the baseline assessment. The reduction in the incidence of ADL attacks was greatest in the patients with the higher grades of lymphoedema. Approximately 66% of the patients perceived an improvement in their swollen limb post-intervention. Eleven patients had grade-II lymphoedema at baseline but only grade-I lymphoedema after being on the CHBC programme for a year (P=0.012). The programme appeared to increase the frequencies with which patients followed each of the limb-care measures considered and most of the measures for the home management of ADL attacks that were investigated. It is recommended that the CHBC programme be implemented as a national programme in Sri Lanka.
An Indigenous case of Plasmodium ovale infection in Sri Lanka
(American Society of Tropical Medicine and Hygiene, 2008) Wickremasinghe, R.; Galappaththi, G.N.; Fernando, W.A.; de Monbrison, F.; Wijesinghe, R.S.; Mendis, K.N.; Picot, S.; Ringwald, P.; Wickremasinghe, A.R.
Plasmodium ovale, which is generally prevalent only in the African region, has been emerging in the Asian and southeast Asian regions. It has not been reported in Sri Lanka. We report, to our knowledge, an indigenous case of P. ovale infection in Sri Lanka. This patient, who was diagnosed by a polymerase chain reaction, had no history of travel overseas or receipt of a transfusion of blood or any blood products, which makes this a likely caseof indigenous transmission. This incidental finding of a P. ovale infection has implications for malaria control in the country and highlights the need to rigorously monitor malaria incidence, as well as prevalent Plasmodium species, with newer and more reliable diagnostics.
Knowledge and perceptions of filariasis in Colombo, Sri Lanka, among patients with chronic filarial lymphoedema
(Academic Press, 2007) Wijesinghe, R.S.; Ekanayake, S.; Perera, M.S.; Wickremasinghe, A.R.
Physical disability and psychosocial impact due to chronic filarial lymphoedema in Sri Lanka
(BioMed Central, 2007) Wijesinghe, R.S.; Wickremasinghe, A.R.; Ekanayake, S.; Perera, M.S.
BACKGROUND: Information on the physical and psychosocial disability of lymphatic filariasis in Sri Lanka is scarce. Therefore this study was carried out to describe the physical disability and psychosocial impact associated with chronic lymphoedema in patients attending filariasis clinics in the Colombo district, Sri Lanka. METHODS: Four hundred and thirteen patients with lymphoedema of limbs attending filariasis clinics in Werahera and Dehiwala in the Colombo district were enrolled in the study after obtaining informed written consent. Data were collected using a pre-tested, interviewer-administered questionnaire and analyzed using SPSS. RESULTS: Majority (95%) of patients had lower limbs affected and there was a significant association with difficulty in walking (p = 0.023). The swollen limb affected the work of 87 (52%) of employed patients and 26 persons reported loss of job. Approximately 25% and 6% reported having problems interacting with the community and family, respectively and 8.7% felt that they were rejected by society. The swollen limb was perceived as a major problem by 36.8% of patients. Of the married persons, 5.7% and 6.2% reported sexual and marital problems respectively, due to their swollen limb/s. Of those who had marital problems, 77.3% reported sexual problems as well (p < 0.001). CONCLUSION: Lymphoedema significantly affects physical, psychological and social functioning in affected individuals. Morbidity control, in addition to control of physical disability, should target the psychosocial consequences.
Physical, psychological, and social aspects of Quality of Life in filarial lymphedema patients in Colombo,Sri Lanka
(SAGE Publishing, 2015) Wijesinghe, R.S.; Wickremasinghe, A.R.
Quality of life (QOL) was assessed in 141 filarial lymphedema patients and 128 healthy people in the Colombo district, Sri Lanka, by administering modified, translated, and validated (in Sri Lanka) versions of the Short Form 36 health survey questionnaire (SF-36) and the 30-item General Health questionnaire (GHQ-30). The GHQ-30 assesses the current mental health status. The SF-36 measures health on 8 multi-item dimensions covering functional state, well-being, and overall evaluation of health (physical functioning, role limitations resulting from physical health problems, role limitations resulting from emotional problems, energy/fatigue, emotional well-being, social functioning, pain and general health). By SF-36, patients experienced poorer physical functioning, more role limitations resulting from physical health conditions, less emotional well-being, poorer social functioning, and more pain than healthy individuals. By GHQ-30, mental well-being of healthy controls was significantly better than that of patients. The significant difference in the QOL as perceived by filarial lymphedema patients and healthy individuals reiterates the importance of morbidity control in patients affected by this disease.
Quality of life in filarial lymphoedema patients in Colombo, Sri Lanka
(Oxford University Press, 2010) Wijesinghe, R.S.; Wickremasinghe, A.R.
The quality of life (QOL) was assessed in 141 filarial lymphoedema patients and 128 healthy people in the Colombo district of Sri Lanka. Information was gathered by administering the validated translated version of the WHO 100-item QOL questionnaire (WHOQOL-100), which ascertains an individual's perception of QOL in the physical, psychological, level of independence, environmental and spiritual domains, as well as the general QOL. Healthy controls had a better QOL in all domains as well as in the overall general QOL, when compared to patients with lymphoedema. Several facets such as pain and discomfort, sleep and rest, activities of daily living, dependence on medication and treatment, working capacity and social support were significantly affected by the acute adenolymphangitis attack/s patients had suffered. The environmental and spiritual domains were significantly affected by the maximum grade of lymphoedema. The significant difference in the QOL as perceived by patients suffering from filarial lymphoedema and apparently healthy individuals reiterates the importance of morbidity control in patients already affected by filarial lymphoedema.
Treatment seeking behavior and treatment practices of lymphatic filariasis patients with Lymphoedema in the Colombo district, Sri Lanka
(SAGE Publishing, 2008) Wijesinghe, R.S.; Wickremasinghe, A.R.; Ekanayake, S.; Perera, M.S.A.
This cross-sectional, descriptive study describes the treatment-seeking behavior of 413 lymphoedema patients attending 2 filariasis clinics in theColombo district, Sri Lanka. A pretested, interviewer-administered questionnaire obtained information regarding sources and types of treatment taken, time taken for diagnosis, and details regarding diethylcarbamazine citrate (DEC) treatment. There was a mean delay of 2.37 years (SD 1.37) in diagnosing filariasis after the first appearance of limb swelling. General practitioners were the most frequent first-contact health care providers and the most visited source overall, followed by government hospitals and Ayurvedic practitioners. Approximately 95% of patients were on DEC treatmentranging from 10 days to 43 years (mean 2.5 years SD +/- 1.1). Sixty-one percent of patients reported always having taken the recommended DEC course. Nonsteroidal anti-inflammatory drugs, diuretics, and antibiotics were liberally prescribed. Approximately 97% had sought treatment from a medical practitioner for an acute adenolymphangitis attack. Despite the area being endemic for filariasis, there was a delay in treatment and inappropriate use of DEC in patients with chronic filarial lymphoedema