Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Spatial and seasonal analysis of human leptospirosis in the District of Gampaha, Sri Lanka(Sri Lankan Society for Microbiology, 2016) Denipitiya, D.T.H.; Chandrasekharan, V.; Abeyewickreme, W.; Viswakula, S.; Hapugoda, M.Leptospirosis is a zoonostic infectious disease, caused by a pathogenic species of the Genus Leptospira. In recent years, a markedly increased number of leptospirosis cases have been reported in the District of Gampaha, in the Western Province of Sri Lanka. Typically, the risk of the disease in the district is seasonal with a small spike occurs in March to May and a large spike occurs during October to December. Objectives of this study were to analyze spatial and seasonal patterns of human leptospirosis and to predict the leptospirosis epidemic trend in the District of Gampaha, Sri Lanka. All Divisional Secretariats (DS) of the district of Gampaha were selected for the study. Epidemiological data were obtained from the Regional Epidemiological Unit, Gampaha. The leptospirosis cases were georeferenced according to DS in where these cases were reported. The cumulative incidence and the fatality were calculated for each DS. Of the georeferenced data, highest mean (±S.E.) of number of leptospirosis cases (72.60 ±15.54) were observed from DS of Mirigama. The highest mean cumulative incidence (4.97±1.10) and case fatality rate (3.88±2.42) were observed from DS of Divulapitiya and Katana respectively. According to past 10 years data on leptospirosis, highest mean numbers of leptospirosis cases were reported in March (51.00±12.99) and November (56.80±8.27). A predictive model for clinically confirmed human leptospirosis was designed for the district by using TSA package of the statistical software R. This study provides an evidence base for reducing disease burden by improving the understanding of the dynamic patterns of the disease in the District of Gampaha, Sri Lanka.Item Risk factors associated with human leptospirosis in the District of Gampaha, Sri Lanka(University of Kelaniya, 2013) Denipitiya, D.T.H.; Athapaththu, M.; Chandrasekharan, N.V.; Abeyewickreme, W.; Hapugoda, M.D.Background & Objective: A large number of leptospirosis cases are recorded in Sri Lanka every year. Increased numbers of cases have been reported in the District of Gampaha in the recent past. The incidence of leptospirosis is often influenced by various socio-economic, occupational, environmental and other factors. To date, a study on potential risk factors has not been conducted in the District of Gampaha. The objective of this study is to identify risk factors involved in transmission of leptospirosis to humans in the District of Gampaha. Methods: Data were collected at the household level, using an interviewer-administered questionnaire and by inspecting the surrounding of laboratory confirmed leptospirosis patients (n=81) and non leptospirosis persons (n=117) during the period of June 2011 to June 2013. The risk factors in the questionnaire were divided into three broad categories: environmental, contact with animals and behavioral/occupational factors. Chi-square test (The SAS System for Windows 9.0) was used for comparison of data from different categories. Results and discussion: 95% of the leptospirosis patients were adult males (77/81) and they had a monthly income of Rs. 10,001-20,000 and 50% of them were agricultural and rental work labourers (40/81). In contrast, 56% of persons not infected with leptospirosis were adult females (66/117) and most of them (48%) were housewives or homemakers (56/117). Data on the type of premises were collected under three categories as poor, moderate and well constructed along with the land use type of the surrounding areas. There were significant statistical associations between the leptospirosis patient with the type of premises (, χ2=23.38, p=0.00), surrounding cleanliness of premises (χ2=45.05, p=0.00), sanitary facilities (χ2=11.66, p=0.00), waste disposal method (χ2=32.23, p=0.00) and age level of patients (χ2=21.07, p=0.00). No significant statistical associations were observed between recorded leptospirosis cases and vegetation coverage in surrounding area of premises (χ2=1.25, p>0.05), source of drinking water (χ2= 0.55, p>0.05) and numbers of persons in family (χ2=0.17, p>0.05). Conclusion: Identification of the potential risk factors would help understand the transmission dynamics of the disease and formulate public health interventions.