Journal/Magazine Articles
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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
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Item Prevalence of enterobiasis among primary school children in Ragama, Sri Lanka(Sri Lanka Medical Association, 2013) Gunawardena, N.K.; Chandrasena, T.G.A.N.; de Silva, N.R.OBJECTIVES: To determine the prevalence of enterobiasis among school children in Ragama Medical Officer of Health (MOH) region and the association between clinical features, potential risk factors and infection status. DESIGN: Cross sectional study. SETTING: School based. Participants 260 school children aged 5-7 years, attending five state schools in the Ragama MOH region. MAIN OUTCOME MEASURES: Prevalence of Enterobius vermicularis infection as diagnosed using adhesive cellophane tapes on the perianal skin on 2 consecutive days. RESULTS: The overall prevalence of enterobiasis was 38%. The risk factors significant on a univariate analysis were male gender, maternal under-education, non-permanency of paternal employment, more household members, more siblings in a family, more persons sleeping with an index child and lack of recent deworming. On a multivariate model more household members, more children in a household, more persons sleeping with the index child, non-permanency of paternal employment and lack of recent deworming were significantly associated with infection. None of the clinical manifestations evaluated (peri-anal itching, insomnia, abdominal pain, and enuresis) showed a significant association with enterobiasis. CONCLUSIONS: Enterobiasis is highly prevalent among primary school children in Ragama.Item Chloroquine resistant falciparum malaria among security forces personnel in the Northern Province of Sri Lanka(Sri Lanka Medical Association, 2004) Hapuarachchi, H.A.C.; Dayanath, M.Y.D.; Abeysundara, S.; Bandara, K.B.A.T.; Abeyewickreme, W.; de Silva, N.R.OBJECTIVE: To determine the occurrence and species distribution of malaria and the extent of chloroquine resistance among security forcespersonnel in a selected region of the Northern Province of Sri Lanka. DESIGN: A descriptive study. SETTING: Mannar District in the Northern Province. METHODS: Nine hundred and seventy five security personnel were screened for malaria by microscopy. Those who were positive were treated withchloroquine and were subjected to 28 day in vivo assay to determine chloroquine resistance. In vitro microtest assay was performed to determine the response of Plasmodium falciparum isolates to chloroquine in vitro. RESULTS: Of the 975 personnel screened, 181 (18.6%) were positive for malaria. P. falciparum was the predominant species (n = 125; 69.1%). The rest were due to P. vivax (n = 42; 23.2%) and mixed infections (n = 14; 7.7%). This was an inversion of the usual species distribution pattern in the country. In vivo assay revealed 38 (53.5%) P. falciparum infections as chloroquine resistant. Fifteen of 23 (65.2%) P. falciparum isolates showed evidence of resistance in vitro. None of the P. vivax infections showed evidence of chloroquine resistance. There was no significant difference in the severity of clinical disease between chloroquine resistant and sensitive infections at first presentation. Recrudescent P. falciparum infections had significantly lower mean parasite densities as well as lower clinical scores at recrudescence than at first presentation. CONCLUSION: Results demonstrate the high prevalence of malaria and chloroquine resistance in the study area and explains several contributory factors for this. There is an urgent need to review antimalarial drug policies in Sri LankaItem Impact of mass chemotherapy on the morbidity due to soil-transmitted nematodes(Elsevier, 2003) de Silva, N.R.This review summarises current knowledge of the ill-effects of soil-transmitted helminthiasis and takes a detailed look at studies that have been published over the past decade describing the effect of mass anthelminthic use on the health of endemic communities. Mass chemotherapy appears to give maximal returns in terms of improved health in areas where hookworm is a major problem and albendazole is used regularly, along with iron supplements; in children it improves physical growth and iron stores, and in pregnant women it reduces the prevalence of iron-deficiency anaemia. In areas where ascariasis is common, the directly attributable benefits of chemotherapy may be minimal, but it can facilitate the entry of other health care programmes in children, because deworming for ascariasis is often much desired and appreciated by the community. In areas with Vitamin A deficiency and endemic ascariasis, Vitamin A supplementation can be combined with deworming: anthelminthics do not impair Vitamin A absorption but the worms may interfere with Vitamin A uptake by reducing fat absorption. Where trichuriasis is a major problem, single dose chemotherapy may take some time to reduce prevalence, but reduction of heavy infections will reduce the incidence of Trichuris Dysentery Syndrome, probably benefit the learning abilities of affected schoolchildren, and may reduce anaemia and stunting. In general, children should be treated as early as possible, and in areas of very high prevalence, thrice-yearly mass chemotherapy probably improves health better than twice-yearly treatment.Item Intestinal helminth infections among children in a slum community in Enderamulla(Sri Lanka Medical Association, 1999) Udayani, W.I.; Uduwevidane, K.; Uvais, A.L.; Wanniarachchi, S.L.; Warnakulasuriya, S.N.; de Silva, N.R.No Abstract availableItem Intestinal parasitoses in the Kandy area, Sri Lanka(SEAMEO Regional Tropical Medicine and Public Health Project, 1994) de Silva, N.R.; de Silva, H.J.; Jayapani, V.P.P.The prevalence of intestinal protozoa and geohelminths was assessed among two diverse populations in the Kandy area: adults attending medical outpatients clinics at the Teaching Hospital Peradeniya, and pre-school children in low-cost housing areas within the Kandy Municipality. In addition to a brief history and examination, a fresh stool sample was obtained and examined by direct smears in saline and iodine, and by formol-ether concentration. The children's stool samples were also examined for Cryptosporidium by cold Ziehl-Neelsen staining. A total of 192 stool samples from the adult outpatients (101 males, age range 15-82 years, mean 51.4 years) and 354 samples from the pre-school children (age range 1-72 months, mean 30 months) were examined. Entamoeba histolytica was not seen in any of the samples; Giardia cysts and Cryptosporidium oocysts were seen in three and one sample respectively from the pre-school children. The overall prevalence of geohelminth infections was 21.3% among the adults and 24.5% among the children. Ascaris lumbricoides was the predominant species in both populations. Comparison of the rate of intestinal parasite infection among 37 adult patients patients with non-specific abdominal complaints, with the rate among 37 matched controls with no abdominal complaints showed no significant difference (16% and 19% respectively). This suggests that the presence of abdominal pain or diarrhea was unrelated to the presence of intestinal parasites in the adult study population. Although the techniques used were not highly sensitive, the absence of E. histolytic probably reflects a true decline in the prevalence of this parasite in Sri LankaItem Prevalence patterns of intestinal parasitoses among school children in Mahaweli System C: a new settlement in Sri Lanka(The Kandy Society of Medicine, 1993) Wijesundera, M. de S.; de Silva, N.R.; Ariyaratne, C.S.SUMMARY: Studentsattending three schools in the settlements of Bakmeedeniya, Ranhelagama and Nagaswewa in Mahaweli System C, were examined at approxi¬mately yearly intervals from December 1986 to November 1989, to assess the prevalence patterns of intestinal parasitoses in the area. The age of the students at the time of examination ranged from 5-19 years, with 89% being in the 5-14 year age group. The male:female ratio was 1:1.1. Faecal smears in saline and iodine were examined for protozoan cysts and helminth ova. Children positive for pathogens were given appropriate therapy. A total of 765 stool samples (from 496 children) were examined: 203 in 1986/87, 365 in 1988 and 197 in 1989. The prevalence of the soil-transmitted helminths was very low throughout, and the rates facAscarislumbricoides, Trichuristrtehiura and hookworm infection was always less than 4 %. Of the intestinal protozoan parasites, the cysts most commonly seen were those of Entamoeba coli, which was found at rates of 16%, 13% and 10% in 1986/87,1988 and 1989 respectively. The commonest pathogenic protozoan was however Giardia intestinalis (positivity rates: 10%, 10% and 8% respectively). lodamoeba butschlii was also detected at low levels, the rates being 3%, 1 % and 2% respectively. E. histolytica was not seen.