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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Epidemiological profile of imported malaria cases in the prevention of reestablishment phase in Sri Lanka(Taylor & Francis, 2022) Dharmawardena, P.; Premaratne, R.; Wickremasinghe, R.; Mendis, K.; Fernando, D.ABSTRACT: Sri Lanka reported the last case of indigenous malaria in October 2012, and received malaria-free certification from WHO in September 2016. Malaria cases have since, shifted from indigenous to imported, and the country remains receptive and vulnerable to malaria. A case-based epidemiological study was conducted on all imported malaria cases reported in the country in 2015 and 2016 with the aim of profiling imported malaria to improve the effectiveness of the surveillance and case management system for malaria. Data were obtained from case reports of the Anti Malaria Campaign, hospital records and laboratory registers. Over the 2 years, 77 imported malaria infections were diagnosed in 54 Sri Lankans and 23 foreign nationals. A majority of the infections were reported among males (93%) in the age group of 21-50 years (85.8%), and all were recent travelers overseas. Most patients were detected by passive case detection, but 10% of cases were detected by Active Case Detection. Only 25% of patients were diagnosed within 3 days of the onset of symptoms. In 32% of patients, the diagnosis was delayed by more than 10 days after the onset of symptoms. Plasmodium falciparum infections manifested significantly earlier after arrival in Sri Lanka than did P.vivax infections. The majority of patients (74%) were diagnosed in the Western Province, which was not endemic for malaria. A third of patients were diagnosed in the private sector. The shift in the epidemiology of malaria infection from before to after elimination has implications for preventing the reestablishment of malaria. KEYWORDS: Imported malaria; case surveillance; delayed diagnosis; epidemiology; prevention of reestablishment; receptivity; risk factors.Item Contribution of the private sector healthcare service providers to malaria diagnosis in a prevention of re-introduction setting(BioMed Central, 2016) Fernando, S.D.; Dharmawardena, P.; Epasinghe, G.; Senanayake, N.; Rodrigo, C.; Premaratna, R.; Wickremasinghe, R.BACKGROUND: Sri Lanka is currently in the prevention of re-introduction phase of malaria. The engagement of the private sector health care institutions in malaria surveillance is important. The purpose of the study was to determine the number of diagnostic tests carried out, the number of positive cases identified and the referral system for diagnosis in the private sector and to estimate the costs involved. METHODS: This prospective study of private sector laboratories within the Colombo District of Sri Lanka was carried out over a 6-month period in 2015. The management of registered private sector laboratories was contacted individually and the purpose of the study was explained. A reporting format was developed and introduced for monthly reporting. RESULTS: Forty-one laboratories were eligible to be included in the study and 28 participated by reporting data on a monthly basis. Excluding blood bank samples and routine testing for foreign employment, malaria diagnostic tests were carried out on 973 individuals during the 6-month period and nine malaria cases were identified. In 2015, a total of 36 malaria cases were reported from Sri Lanka. Of these, 24 (67 %) were diagnosed in the Colombo District and 50 % of them were diagnosed in private hospitals. CONCLUSIONS: An equal number of cases were diagnosed from the private sector and government sector in the Colombo District in 2015. The private sector being a major contributor in the detection of imported malaria cases in the country should be actively engaged in the national malaria surveillance system.