IPRC - 2016
Permanent URI for this collectionhttp://repository.kln.ac.lk/handle/123456789/157
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Item Characterization of a Dengue Positive Population in Colombo Municipal Council (CMC) Medical Officer of Health (MOH), Colombo(Faculty of Graduate Studies, University of Kelaniya, Sri Lanka, 2016) Lakmal, M.G.K.; Udayanga, N.W.B.A.L.; Gunathilaka, P.A.D.H.N.; Fernando, S.D.; Karunathilaka, K.; Abeyewickreme, W.Dengue that has caused 29,777 suspected infections in 2015 has emerged the most challenging health issue faced in Sri Lanka. Approximately 51% of dengue infections are reported from the Western Province. The susceptibility of a population to dengue is influenced by a combination of socio-economic, environmental and epidemiological factors. The current study was conducted to characterize a population of dengue patients residing in a high dengue risk area in terms of their socio-economic appearance. An interviewer administrated questionnaire was used to collect information on the socio-economic aspects of a group of 140 randomly selected dengue positive patients residing in Colombo Municipal Council (CMC) Medical Officer of Health (MOH) area. Out of 140, a majority (63.6%, n=89) were females, while the age groups of 31-40 and 21-30 years were recognized as the most susceptible age groups for dengue. High proportion of the patients (79.3%, n=111) were having an educational level below secondary school (O/L) with a total family income below 20,000 LKR (80.7%, n=113). All the homesteads were smaller (<5 perch) in size, with small roads for access (77.1%, n=108) and/or a footpath (22.9%, n=32) as the access route. Majority of the households (69.3%, n=97) were temporary with moderate conditions (51.4%, n=72), that were mainly utilized for both residential and commercial purposes (63.5%, n=89) at once. In a majority of households’ solid waste was disposed within 7 days (62.1%) via the Municipal Council or by keeping near the main roads (37.9%). Source separation of waste, home gardening and composting by the study population was minimal (n=137, 97.9%). Pipe water remained as the only water source while approximately 27.9% (n=39) households were lacking sanitary facilities. Use of mosquito coils and bed-nets were the most preferred mosquito biting prevention methods. Low educational level, income, poor living conditions and limitations in solid waste disposal methods were recognized as potential risk factors for high infection rates of dengue in this population. Special focus should be given to these key areas by the relevant vector controlling authorities in order to facilitate controlling of dengue outbreaks within the CMC area.Item Eliminating female Aedes mosquitoes by spiking blood meals with toxicants as a sex separation method in the context of the sterile insect technique and Incompatible Insect Technique(Faculty of Graduate Studies, University of Kelaniya, Sri Lanka, 2016) Ranathunga, R.M.T.B.; Gunathilaka, P.A.D.H.N.; Udayanga, N.W.B.A.L.; Wijegunawardena, N.D.A.; Abeyewickreme, W.Ivermectin and spinosad have longevity reducing effects in several insect species, including disease transmitting mosquitoes after feeding blood contaminated with above toxicants on hosts. Therefore, this approach could play an enormous role in mosquito control operations by its use in the female elimination process during mass-rearing, enabling the release of only sterile males in the context of the sterile insect technique (SIT) and incompatible insect technique (IIT) with Wolbachia bacterium. Blood meals of cattle origin were spiked with diffeerenct concentrations (2, 4, 6, 8 and 10 ppm) of Ivermectin (Ivotec, 1% w/v) and Spinosad (Spinosyn, 12% w/v) and offered to a batch of adult Ae. aegypti (n = 300) and Ae. albopictus (n = 300) having 1:1 sex ratio in order to obtain an optimal dose for quick and total female elimination. After 24 hours all remaining females and males were aspirated out and transferred in to new cages separately. An additional blood meal with the initially fed concentrations of ivermectin and spinosad was provided after 24 hours, followed by a 48-hour observation of mortality. This experiment was repeated by feeding cattle blood containing a mixture of ivermectin and spinosad in 1:1 ratio from each concentration. Spiked blood with 8 ppm ivermectin and spinosad killed all the fed females of Ae aegypti and Ae. abopictus within 24 to 48 hours. It was observed that the number of fed females gradually increased, when decreasing the toxicity in combination of ivermectin and spinosad (1:1) in blood for both species. Male mortality did not show any significant differences during the study. Mixed feeding of blood with 8 ppm ivermectin and 8 ppm spinosad have shown as the viable treatment to eliminate female Ae aegypti and Ae. abopictus from laboratory colonies.Item Prevalence of NS-1 Status of Clinically Suspected Dengue Patients in a Selected Out-Patient Setting(Faculty of Graduate Studies, University of Kelaniya, Sri Lanka, 2016) Kodikara, K.; Jayathilake, S.; Kumarasinghe, B.; Muhandiramlage, T.; Gunesakera, D.; Fujii, Y.Dengue infection is one of the rapidly emerging arboviral infections in the world. It is a cause of significant morbidity and mortality especially in developing countries. Although most dengue infections are asymptomatic, dengue fever can be manifested with or without complications. Early diagnosis of dengue is important both clinicians and the patients, where appropriate management of dengue patients reduces both morbidity and mortality. Traditionally dengue infection is clinically suspected with full blood count aided by clinical features although dengue infection cannot be confirmed by either of these methods. Confirmatory tests for detection of the dengue virus are by virus isolation or by nucleic acid detection. which are not suitable for routine diagnosis. NS-1 rapid antigen test has become available for early detection of dengue NS1 antigen, which can be performed at the point of care. Estimate the prevalence of NS1 positivity in dengue suspected patients with acute febrile illness in a selected study setting Blood samples from clinically suspected patients within the first five days of fever were sent for NS1 diagnosis to the molecular laboratory in the department of Biochemistry Faculty of Medicine Ragama. Clinical diagnosis was made by a medical officer. Serum was used for the NS1 diagnosis using Inbios Diagnostic kit (USA). 22.2% of samples were tested positive for NS-1 antigen in a total of 54 samples collected. There were 53.7% males. 9.2% patients were below 10 years of age, 37% patients between 11-20 years of age, 20.3% patients between 21-30 years and 31.4% patients above 31 years of age. 30 % of patients between 11-20 years were NS-1 positive. 36.3 % of patients between 21-30 years of age and 11.7% patients above 31 years of age were also NS-1 positive. NS-1 antigen prevalence was highest among patients between the ages of 11-30 years. Initial clinical assessment of dengue infections is of low specificity as the disease manifests as an undifferentiated febrile illness. Therefore, the inclusion of an antigen test will improve the specificity of diagnosis in a similar out-patient setting which will enable clinicians to make decisions on the further management of the condition.