Journal/Magazine Articles
Permanent URI for this collectionhttp://repository.kln.ac.lk/handle/123456789/13
This collection contains original research articles, review articles and case reports published in local and international peer reviewed journals by the staff members of the Faculty of Medicine
Browse
14 results
Search Results
Item Lymphatic filariasis in the Southeast Asian region; status and control options.(CABI Publishing, 2020) Chandrasena, T.G.A.N.; Premaratna, R.; Mallawarachchi, C.H.; Gunaratna, D.G.A.M.; de Silva, N.R.ABSTRACT: The Global Program to Eliminate Lymphatic Filariasis (GPELF) was launched in year 2000 by the World Health Organization (WHO) with the goal set for elimination by 2020. Over half the global disease burden lies in the Southeast Asian region (SEAR). The preventive chemotherapy (PC) programme has been initiated in all the WHO SEAR member states with varying levels of progress. Maldives, Sri Lanka and Thailand have achieved the goal of elimination as a public health problem (EPHP) within the stipulated period with Bangladesh working towards validation in 2021. Both Sri Lanka and Thailand are continuing with post-validation surveillance combined with selective treatment, striving for zero transmission in-parallel with the morbidity management and disability prevention program (MMDP). Timor-Leste appears close to reaching critical transmission thresholds with 100% coverage and triple therapy in the last round of PC. Data on MMDP activities are insufficient to comment on reaching EPHP status. PC coverage and country reports indicate ongoing transmission in Nepal, Myanmar, Indonesia and India requiring further rounds of PC. The PELF has made considerable progress in the SEAR towards elimination but there still remain significant transmission and disease burden in the highly populated countries in SEAR.Item Morbidity management and disability prevention for lymphatic filariasis in Sri Lanka: Current status and future prospects(Public Library of Science, 2018) Chandrasena, N.; Premaratna, R.; Gunaratne, I.E.; de Silva, N.R.BACKGROUND: Sri Lanka was acknowledged to have eliminated lymphatic filariasis (LF) as a public health problem in 2016, largely due to its success in Mass Drug Administration (MDA) to interrupt disease transmission. Analysis of the Strengths, Weaknesses, Opportunities and Threats (SWOT) of the national Morbidity Management and Disability Prevention (MMDP) program, the other pillar of the LF control program, was carried out with the objective of evaluating it and providing recommendations to optimize the use of available resources. METHODOLOGY: A situation analysis of the MMDP activities provided by the state health sector was carried out using published records, in-depth interviews with key informants of the Anti Filariasis Campaign, site-visits to filariasis clinics with informal discussions with clinic workforce and personal communications to identify strengths and weaknesses; and opportunities to overcome weaknesses and perceived threats to the program were explored. The principal strength of the MMDP program was the filariasis clinics operational in most endemic districts of Sri Lanka, providing free health care and health education to clinic attendees. The weaknesses identified were the low accessibility of clinics, incomplete coverage of the endemic region and lack of facilities for rehabilitation. The perceived threats were diversion of staff and resources for control of other vector-borne infections, under-utilization of clinics and non-compliance with recommended treatment. Enhanced high level commitment for MMDP, wider publicity and referral systems, integration of MMDP with other disease management services and collaboration with welfare organizations and research groups were identified as opportunities to overcome weaknesses and challenges. CONCLUSIONS: The recommended basic package of MMDP was functional in most of the LF-endemic region. The highlighted weaknesses and challenges, unless addressed, may threaten program sustainability. The identified opportunities for improvement of the programme could ensure better attainment of the goal of the MMDP program, namely access to basic care for all affected by lymphatic filarial disease.Item Surveillance for transmission of lymphatic filariasis in Colombo and Gampaha districts of Sri Lanka following mass drug administration(Oxford University Press, 2016) Chandrasena, T.G.A.N.; Premaratna, R.; Samarasekera, D.S.; de Silva, N.R.BACKGROUND: Sri Lanka was recently declared by WHO to have eliminated lymphatic filariasis as a public health problem, after conclusion of annual mass drug administration. Our aim was to assess the lymphatic filariasis situation, following mass drug administration. METHODS: Surveillance was done in two districts of the Western Province in two consecutive phases (2009-2010 and 2013-2015), by examining 2461 thick night blood smears and performing 250 dipstick tests on children for antibodies to Brugia malayi. RESULTS AND CONCLUSIONS: Decline in bancroftian microfilaraemia (microfilaria rate 0.32% to zero) supports elimination, but re-emergence of brugian filariasisis (antibody rate, 1.6%; one microfilaria positive) is a cause for concern.Item Integrated school-based surveillance for soil-transmitted helminth infections and lymphatic filariasis in Gampaha district, Sri Lanka(American Society of Tropical Medicine and Hygiene, 2014) Gunawardena, S.; Gunawardena, N.K.; Kahathuduwa, G.; Karunaweera, ND.; de Silva, N.R.; Ranasinghe, U.B.; Samarasekara, S.D.; Nagodavithana, K.C.; Rao, R.U.; Rebollo, M.P.; Weil, G.J.We explored the practicality of integrating surveillance for soil-transmitted helminthiasis (STH, assessed by Kato-Katz) with transmission assessment surveys for lymphatic filariasis (LF) in two evaluation units (EUs) in Gampaha district, Sri Lanka (population 2.3 million). The surveys were performed 6 years after five annual rounds of mass drug administration with diethylcarbamazine and albendazole. Each transmission assessment survey tested children (N = 1,462 inland EU; 1,642 coastal EU) sampled from 30 primary schools. Low filarial antigenemia rates (0% and 0.1% for the inland and coastal EUs) suggest that LF transmission is very low in this district. The STH rates and stool sample participation rates were 0.8% and 61% (inland) and 2.8% and 58% (coastal). Most STH detected were low or moderate intensity Trichuris trichiura infections. The added cost of including STH testing was ∼$5,000 per EU. These results suggest that it is feasible to integrate school-based surveillance for STH and LFItem Effect of repeated mass chemotherapy for filariasis control on soil-transmitted helminth infections in Sri Lanka(Sri Lanka Medical Association, 2008) Gunawardena, N.K.; Amarasekera, N.D.D.M.; Pathmeswaran, A.; de Silva, N.R.BACKGROUND: In July 2006 Sri Lanka completed 5 rounds of annual mass drug administration (MDA) with diethylcarbamazine citrate (DEC) and albendazole as part of its national programme for elimination of lymphatic filariasis (LF). Albendazole is highly effective against soil-transmitted helminths (STH). This study was carried out to assess the effect of repeated annual MDA on STH infections in the Western Province of Sri Lanka, an area co-endemic for LF and STH. METHODS: Faecal samples were obtained (during August-September 2006), from grade 5 students in 17 schools in the Western Province that were included in a national survey of schoolchildren's health in 2003, and examined using the modified Kato-Katz technique. The prevalence and intensity of roundworm, whipworm and hookworm infections in 2003 and 2006 were compared. RESULTS: Faecal samples from 255 children were examined in 2003; 448 were examined in 2006. Roundworm prevalence was marginally lower in 2006 (4.0%) than in 2003 (4.7%), as was hookworm (0.2% vs 0.4%), whereas whipworm prevalence was higher (13.8% vs 9.4%). These differences as well as that between the geometric mean egg counts were not statistically significant. Compliance with MDA in 2006, as reported by the schoolchildren examined, was only 59%. CONCLUSIONS: Four annual rounds of MDA with DEC and albendazole had virtually no effect on STH infections in the study area.Item Controlling lymphatic filariasis and soil-transmitted helminthiasis together in South Asia: opportunities and challenges(Oxford University Press, 2006) Padmasiri, E.A.; Montresor, A.; Biswas, G.; de Silva, N.R.Item Filarial antigens detected in urine using the immunochromatographic card test(Sri Lanka Medical Association, 2006) Adikaram, N.D.; de Silva, N.R.; Fernando, A.; Fernando, D.; Lamabadasuriya, S.; Reid, C.B.No Abstract Available.Item Lymphoedema management knowledge and practices among patients attending filariasis morbidity control clinics in Gampaha district, Sri Lanka(BioMed Central, 2004) Chandrasena, T.G.A.N.; Premaratna, R.; de Silva, N.R.BACKGROUND: Little information is available on methods of treatment practiced by patients affected by filarial lymphoedema in Sri Lanka. The frequency and duration of acute dematolymphangioadenitis (ADLA) attacks in these patients remain unclear. This study reports the knowledge, practices and perceptions regarding lymphoedema management and the burden of ADLA attacks among patients with lymphoedema. METHODS: A semi-structured questionnaire was used to assess morbidity alleviation knowledge, practices and perceptions. The burden of ADLA attacks was assessed using one-year recall data. RESULTS: 66 patients (22 males, 44 females) with mean age 51.18 years (SD +/- 13.9) were studied. Approximately two thirds of the patients were aware of the importance of skin and nail hygiene, limb elevation and use of footwear. Washing was practiced on a daily and twice daily basis by 40.9 percent and 48.5 percent respectively. However, limb elevation, exercise and use of footwear were practiced only by 21-42.4 percent (while seated and lying down), 6 percent and 34.8 percent respectively. The majority of patients considered regular intake of diethylcarbamazine citrate (DEC) important. Approximately two thirds (65.2 percent) had received health education from filariasis clinics. Among patients who sought private care (n = 48) the average cost of treatment for an ADLA attack was Rs. 737.91. Only 18.2 percent had feelings of isolation and reported community reactions ranging from sympathy to fear and ridicule. CONCLUSIONS: Filariasis morbidity control clinics play an essential role in the dissemination of morbidity control knowledge. Referral of lymphoedema patients to morbidity control clinics is recommendedItem Impact of mass chemotherapy for the control of filariasis on geohelminth infections in Sri Lanka(Academic Press, 2003) de Silva, N.R.; Pathmeswaran, A.; Fernando, S.D.; Weerasinghe, C.R.; Selvaratnam, R.R.; Padmasiri, E.A.; Montresor, A.No Abstract AvailableItem Complicance with single-dose diethylcarbamazine citrate (DEC) mass treatment programme for filariasis in Colombo, Sri Lanka(World Health Organization Regional Office for South-East Asia, 2002) Weerasinghe, C.R.; Abeyewickreme, W.; de Silva, N.R.Available