Medicine
Permanent URI for this communityhttp://repository.kln.ac.lk/handle/123456789/12
This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
Browse
12 results
Search Results
Item Intestinal Nematodes: Ascariasis(Elsevier, 2020) Bundy, D.A.P.; de Silva, N.R.; Appleby, L.J.; Brooker, S.J.Ascariasis is the most prevalent human helminth infection, with an estimated 819 million infections worldwide. Transmission primarily occurs in warm, tropical climates that lack water and sanitation facilities and have poor hygiene. Worms inhabit the small intestine, and morbidity is related to worm burden. A small proportion of the infected population harbors the majority of worms, with intense infection most common in school-age children, and intensity and prevalence declining to a low level throughout adulthood. School-age children are therefore the targets for school-based community control efforts in large-scale treatment campaigns. Light infections can affect growth and development, whereas, due to the size of the worms, heavier worm burdens can result in intestinal obstruction, particularly in young children. Treatment with mebendazole or albendazole is efficacious, with cure rates of >90% commonly achieved.Item Intestinal nematodes that migrate through lungs (Ascariasis)(WB Saunders Company, 2000) de Silva, N.R.; Bundy, D.A.P.Item Helminth infections: soil-transmitted helminth infections and schistosomiasis(Oxford University Press and World Bank, 2006) Hotez, P. J.; Bundy, D.A.P.; Beegle, K.; Brooker, S.; Drake, L.; de Silva, N.; Montresor, A.; Engels, D.; Jukes, M.; Chitsulo, L.; Chow, J.; Laxminarayan, R.; Michaud, C. M.; Bethony, J.; Correa-Oliviera, R.; Xiao Shu-Hua; Fenwick, A.; Savioli, L.Item Intestinal Nematodes: Ascariasis(Saunders-Elsevier, 2012) Bundy, D.A.P.; de Silva, N.; Brooker, S.Item 100 Years of Mass Deworming Programmes: A Policy Perspective From the World Bank's Disease Control Priorities Analyses(London : Academic Press, 2018) Bundy, D.A.P.; Appleby, L.J.; Bradley, M.; Croke, K.; Hollingsworth, T.D.; Pullan, R.; Turner, H.C.; de Silva, N.For more than 100 years, countries have used mass drug administration as a public health response to soil-transmitted helminth infection. The series of analyses published as Disease Control Priorities is the World Bank's vehicle for exploring the cost-effectiveness and value for money of public health interventions. The first edition was published in 1993 as a technical supplement to the World Bank's World Development Report Investing in Health where deworming was used as an illustrative example of value for money in treating diseases with relatively low morbidity but high prevalence. Over the second (2006) and now third (2017) editions deworming has been an increasingly persuasive example to use for this argument. The latest analyses recognize the negative impact of intestinal worm infection on human capital in poor communities and document a continuing decline in worm infection as a result of the combination of high levels of mass treatment and ongoing economic development trends in poor communities.Item Universal health coverage and intersectoral action for health: key messages from Disease Control Priorities, 3rd edition(Elsevier, 2018) Jamison, D.T; Alwan, A.; Mock, C.N.; Nugent, R.; Watkins, D.; Adeyi, O.; Anand, S.; Atun, R.; Bertozzi, S.; Bhutta, Z.; Binagwaho, A.; Black, R.; Blecher, M.; Bloom, B.R.; Brouwer, E.; Bundy, D.A.P.; Chisholm, D.; Cieza, A.; Cullen, M.; Danforth, K.; de Silva, N.; Debas, H.T.; Donkor, P.; Dua, T.; Fleming, K.A.; Gallivan, M.; Garcia, P.J.; Gawande, A.; Gaziano, T.; Gelband, H.; Glass, R.; Glassman, A.; Gray, G.; Habte, D.; Holmess, K.K.; Horton, S.; Hutton, G.; Jha, P.; Knaul, F.M.; Kobusingye, O.; Krakauer, E.L.; Kruk, M.E.; Lechmann, P.; Laxminarayan, R.; Levin, C.; Looi, L.M.; Madhav, N.; Mahmoud, A.; Mbanya, J.C.; Measham, A.; Medina-Mora, M.E.; Medin, C.; Mills, A.; Mills, J.A.; Montoya, J.; Norheim, O.; Olson, Z.; Omokhodion, F.; Oppenheim, B.; Ord, T.; Patel, V.; Patton, G.C.; Peabody, J.; Prabhakaran, D.; Qi, J.; Reynolds, T.; Ruacan, S.; Sankaranarayan, R.; Sepulveda, J.; Skolnik, R.; Smith, K.R.; Temmerman, M.; Tollman, S.; Verguet, S.; Walker, D.G.; Walker, N.; Wu, Y.; Zhao, K.The World Bank is publishing nine volumes of Disease Control Priorities, 3rd edition (DCP3) between 2015 and 2018. Volume 9, Improving Health and Reducing Poverty, summarises the main messages from all the volumes and contains cross-cutting analyses. This Review draws on all nine volumes to convey conclusions. The analysis in DCP3 is built around 21 essential packages that were developed in the nine volumes. Each essential package addresses the concerns of a major professional community (eg, child health or surgery) and contains a mix of intersectoral policies and health-sector interventions. 71 intersectoral prevention policies were identified in total, 29 of which are priorities for early introduction. Interventions within the health sector were grouped onto five platforms (population based, community level, health centre, first-level hospital, and referral hospital). DCP3 defines a model concept of essential universal health coverage (EUHC) with 218 interventions that provides a starting point for country-specific analysis of priorities. Assuming steady-state implementation by 2030, EUHC in lower-middle-income countries would reduce premature deaths by an estimated 4·2 million per year. Estimated total costs prove substantial: about 9·1% of (current) gross national income (GNI) in low-income countries and 5·2% of GNI in lower-middle-income countries. Financing provision of continuing intervention against chronic conditions accounts for about half of estimated incremental costs. For lower-middle-income countries, the mortality reduction from implementing the EUHC can only reach about half the mortality reduction in non-communicable diseases called for by the Sustainable Development Goals. Full achievement will require increased investment or sustained intersectoral action, and actions by finance ministries to tax smoking and polluting emissions and to reduce or eliminate (often large) subsidies on fossil fuels appear of central importance. DCP3 is intended to be a model starting point for analyses at the country level, but country-specific cost structures, epidemiological needs, and national priorities will generally lead to definitions of EUHC that differ from country to country and from the model in this Review. DCP3 is particularly relevant as achievement of EUHC relies increasingly on greater domestic finance, with global developmental assistance in health focusing more on global public goods. In addition to assessing effects on mortality, DCP3 looked at outcomes of EUHC not encompassed by the disability-adjusted life-year metric and related cost-effectiveness analyses. The other objectives included financial protection (potentially better provided upstream by keeping people out of the hospital rather than downstream by paying their hospital bills for them), stillbirths averted, palliative care, contraception, and child physical and intellectual growth. The first 1000 days after conception are highly important for child development, but the next 7000 days are likewise important and often neglected.Item Investment in child and adolescent health and development: key messages from Disease Control Priorities, 3rd Edition(Elsevier, 2018) Bundy, D.A.P.; de Silva, N.; Horton, S.; Patton, G.C.; Schultz, L.; Jamison, D.T.; Disease Control Priorities-3 Child and Adolescent Health and Development Authors GroupThe realisation of human potential for development requires age-specific investment throughout the 8000 days of childhood and adolescence. Focus on the first 1000 days is an essential but insufficient investment. Intervention is also required in three later phases: the middle childhood growth and consolidation phase (5-9 years), when infection and malnutrition constrain growth, and mortality is higher than previously recognised; the adolescent growth spurt (10-14 years), when substantial changes place commensurate demands on good diet and health; and the adolescent phase of growth and consolidation (15-19 years), when new responses are needed to support brain maturation, intense social engagement, and emotional control. Two cost-efficient packages, one delivered through schools and one focusing on later adolescence, would provide phase-specific support across the life cycle, securing the gains of investment in the first 1000 days, enabling substantial catch-up from early growth failure, and leveraging improved learning from concomitant education investments.Item Unresolved issues in anthelmintic pharmacology for helminthiases of humans(Elsevier, 2010) Geary, T.G.; Woo, K.; McCarthy, J.S.; Mackenzie, C.D.; Horton, J.; Prichard, R.K.; de Silva, N.R.; Olliaro, P.L.; Lazdins-Helds, J.K.; Engels, D.A.; Bundy, D.A.P.Helminth infections are an important constraint on the health and development of poor children and adults. Anthelmintic treatment programmes provide a safe and effective response, and increasing numbers of people are benefitting from these public health initiatives. Despite decades of clinical experience with anthelmintics for the treatment of human infections, relatively little is known about their clinical pharmacology. All of the drugs were developed initially in response to the considerable market for veterinary anthelmintics in high- and middle-income countries. In contrast, the greatest burden caused by these infections in humans is in resource-poor settings and as a result there has been insufficient commercial incentive to support studies on how these drugs work in humans, and how they should best be used in control programmes. The advent of mass drug administration programmes for the control of schistosomiasis, lymphatic filariasis, onchocerciasis and soil-transmitted helminthiases in humans increases the urgency to better understand and better monitor drug resistance, and to broaden the currently very narrow range of available anthelmintics. This provides fresh impetus for developing a comprehensive research platform designed to improve our understanding of these important drugs, in order to bring the scientific knowledge base supporting their use to a standard equivalent to that of drugs commonly used in developed countries. Furthermore, a better understanding of their clinical pharmacology will enable improved therapy and could contribute to the discovery of new productsItem Can we deworm this wormy world?(Oxford University Press, 1998) Bundy, D.A.P.; de Silva, N.R.While programmes such as the Rockefeller campaign were specifically targeted at a particular parasite species, the current trend is towards the simultaneous control of all the major geohelminth species. New, broad-spectrum, low-cost anthelmintics and new understanding of epidemiology have led to more cost-effective and sustainable strategies. The WHO, UNICEF and the World Bank all now support global and regional efforts to achieve control of morbidity from intestinal worms. In this paper, we aim to show what's new in clinical helminthology and what has brought about the great improvement in the success of the new approaches to control.Item Worm burden in intestinal obstruction caused by Ascaris lumbricoides(Blackwell Scientific Publications, 1997) de Silva, N.R.; Guyatt, H.L.; Bundy, D.A.P.Examination of 24 case reports suggests the worm burden in those presenting to hospital with intestinal obstruction is > 60 and is about tenfold higher in fatal cases.