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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty

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    Comparative analysis of the larvicidal activity of temephos (EC50) and novaluaron (EC10) to control Anopheles stephensi in Sri Lanka
    (Elsevier, 2023) Jude, J.; Gunathilaka, N.; Udayanga, L.; Fernando, D.; Premarathne, P.; Wickremasinghe, R.; Abeyewickreme, W.
    Background: Anopheles stephensi was first recorded in the coastal area of Mannar District, Sri Lanka, in December 2016. Since then, this vector has been isolated from other districts in the Northern and Eastern Provinces of Sri Lanka. Chemical control is the main arm of vector control that can be used to reduce the vector densities within a short period. Thus, the present study aimed at evaluating the efficacy of using selected insecticides for the control of An. stephensi larvae. Method: The third and fourth instar larval stages of An. stephensi (F2 generation) of field mosquitoes that were caught using cattle baited net trap collections from Columbuthurai, Kurunagar, and Navanthurai areas in Jaffna District, Sri Lanka, were obtained from the laboratory colony established at Jaffna. Batches of 100 larvae were taken for experiments and introduced separately to a concentration series of temephos and novaluron (0.04-400 ppm). A control test was also performed at each setup without introducing insecticides. The mortality rates of An. stephensi larvae exposed to different concentrations of larvicides were recorded at 1, 24 and 48-h intervals. The experiment was replicated five times at individual concentrations for each selected chemical. Data were analyzed using the General Linear Model (GLM) and Probit analysis. Results: The highest mortality rate (100%) at a 1-h exposure period was observed from temephos at >100 ppm. The mortality rates varied significantly for different concentrations and larvicides (p < 0.05). At 24-h of the exposure period, the 100% mortality of An. stephensi larvae were observed from both temephos and novaluron even at 0.04 ppm. Conclusion: Both temephos and novaluron reported 100% mortality rates in An. stephensi larvae at 1-h and 24-h exposure periods. Based on the findings, temephos and novaluron can be recommended as effective larvicides for chemical-based control of An. stephensi in Jaffna, Sri Lanka. Further, it is recommended to conduct a field-based study, where habitat types and water quality are highly heterogeneous and may affect the residual activity.
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    Biology, bionomics and life-table studies of Anopheles stephensi (Diptera: Culicidae) in Sri Lanka and estimating the vectorial potential using mathematical approximations
    (Elsevier, 2023) Jude, J.; Gunathilaka, N.; Udayanaga, L.; Fernando, D.; Premarathne, P.; Wickremasinghe, R.; Abeyewickreme, W.
    Background: Anopheles stephensi is an invasive mosquito in Sri Lanka that can potentially transmit malaria. The transmission intensity is linked with biology, bionomic and behavioral aspects of a vector that are associated with the Vectorial Capacity (VC). However, the influence of larval conditions eventually affects the vectorial potential of An. stephensi are not well understood. Methods: A colony of An. stephensi was established at the Regional Centre of the Open University of Sri Lanka, Jaffna District. The colony was maintained under confined conditions according to standard protocols. Biotypes of An. stephensi were characterized by referring to the number of egg ridges. Information on (a) biological aspects of eggs (duration for egg hatching, egg development and hatchability), (b) larval development time, larval survivorship pupation success, resting depth of larvae), (c) pupae (adult emergence rate, average time for adult emergence) and (d) adults (biting frequency, mating success gonotrophic cycle, fecundity, duration for egg-laying, percentage of sexes, adult survival/longevity) were evaluated under life-table analysis. Further, selected morphometric characters of each life cycle stage were recorded from the eggs (length and breadth), larvae (head length, width of head, length of thorax, width of thorax, length of abdomen, width of abdomen, and the total length of larvae), pupae (cephalothoracic length and width) and adults (length & width of wing, thorax and abdomen). The VC was calculated using a mathematical-based approach. Descriptive statistics, General Linear Model (GLM) and independent-sample t-test were used for the statistical analysis. Results: All three biotypes were identified based on egg morphology. Mysorensis biotype (47%; n = 470) was predominant followed by type (38.1%; n = 381) and intermediate (14.9%; n = 149). The mean egg length (F(2,997) = 3.56; P = 0.029) and breadth (F(2,997) = 4.57; P = 0.011) denoted significant differences among the three biotypes. The mating success of females observed was 80.7 ± 4.45%. The mean hatching period was 1.9 ± 0.03 days, with a hatching rate of 86.2 ± 0.77%. Overall, 8.0 ± 0.14 days were required for larval development and 30.3 ± 0.14 h were spent in the pupal stage. The pupation success was 94.5 ± 0.37%, and the majority were males (53.1 ± 0.73%). The mean fecundity was 106.5 ± 6.38 eggs and a gonotrophic cycle of 3.4 ± 0.06 days. The female survival rate was 43.2 ± 2.4%, with a mean biting frequency of 66.6 ± 3.5%. The average VC of adult An. stephensi was estimated to be 18.7. Conclusions: The type biotype, which is an effective vector in the Indian subcontinent is present in Sri Lanka. According to the mathematical approximation, An. stephensi found locally has a vectorial capacity of over 18. Therefore, this study warrants the health authorities and vector control programmes to continue the entomological surveys, monitoring of vector densities and implementing appropriate vector control interventions based on biology and bionomic information of vectors.
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    Developmental responses and survival of Anopheles stephensi larval stages at different salinity levels
    (Royal Society of Tropical Medicine and Hygiene, 2022) Jude, J.; Gunathilaka, N.; Udayanaga, L.; Fernando, D.; Premarathne, P.; Wickremasinghe, R.; Abeyewickreme, W.
    BACKGROUND: Anopheles stephensi is a newly invaded vector in Sri Lanka. It has been identified in coastal areas in the northern and eastern parts of the country and evidences the ability to breed in brackish water environments. METHODS: Laboratory investigations were conducted with batches of 100 first and third instar larvae exposed to a salinity gradient (0-40 ppt). Survival rates at 1 h, 24 h and until pupation were recorded for first and third instar larvae at different salinity levels. The experiment was repeated four times for both instars. Data were analysed using the general linear model and probit analysis. RESULTS: Significant variations in adult emergence were observed from both larval stages at different salinity levels (p<0.05). The highest pupation rates were observed at 2.5 ppt salinity. The survival rate of first instar larvae after 24 h of salinity exposure was >80% up to 12.5 ppt, while 100% mortality was observed for from the ≥25 ppt level of salinity. More than 90% of the third instar larvae pupated from salinity levels <15 ppt. The lowest survival rate was reported as 15.8±2.47% at 25 ppt. CONCLUSIONS: This indicates a high potential of increasing density of A. stephensi in coastal ecosystems in lagoons and other saline water bodies. Hence it is high time to redesign vector control interventions for vector breeding in coastal ecosystems.
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    Water quality characteristics of breeding habitats in relation to the density of Aedes aegypti and Aedes albopictus in domestic settings in Gampaha district of Sri Lanka
    (Elsevier, 2022) Dalpadado, R.; Amarasinghe, D.; Gunathilaka, N.
    In spite of the unavailability of measures to target dengue control in human populations, the promising way of combating the disease is by controlling vector mosquito larvae and their breeding habitats. Water quality characteristics of the breeding habitats of dengue vectors are among the crucial parameters that determine the female mosquito's oviposition and breeding. Therefore, a cross-sectional study was conducted to investigate the habitat characteristics of dengue vector mosquitoes by assessing the water quality of positive breeding habitats using the weighted arithmetic water quality index (WQI). The present study was conducted in domestic areas of the selected medical officer of health areas of the Gampaha district, Sri Lanka, from 2017 to 2019. Water quality characteristics of breeding habituations were measured and analyzed. The relationship between water quality parameters in breeding habitats with the occurrence of mosquito species was assessed using Kruskal-Wallis one-way analysis of variance, followed by pairwise comparison using Dunn's test and Mann-Whitney U test at a 5% level of significance. This study revealed that the temperature of Aedes mosquito breeding water ranged between 25.3 and 39.8 °C, and bred at temperatures as high as 39.8 °C in discarded receptacles. The results indicated that Ae. aegypti was prominent in alkaline water ranging between 7.5 and 8.5 pH, whereas Ae. albopictus was abundant in water with a pH range of 6.5-7.5. Both species of Aedes inhabited waters of low turbidity and TDS level. Ae. aegypti and Ae. albopictus immatures were prominent in water where TDS levels ranged between 250 and 350 ppm. The mean conductivity in the mosquito breeding water was recorded as 228.3 ± 63.9 µs/cm. The study revealed that Aedes mosquitoes could breed in water with a mean dissolved oxygen level of 6.9 ± 0.7 mg/L, ranging between 6.35 ± 1.09 mg/L and 7.28 ± 0.26 mg/L. The water quality indices were calculated for the eight previously identified breeding habitat categories of Aedes mosquitoes.
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    Larval indices of vector mosquitoes as predictors of dengue epidemics: An approach to manage dengue outbreaks based on entomological parameters in the districts of Colombo and Kandy, Sri Lanka
    (Hindawi Pub. Co., 2020) Udayanga, L.; Aryaprema, S.; Gunathilaka, N.; Iqbal, M. C. M.; Fernando, T.; Abeyewickreme, W.
    BACKGROUND: Early detection of dengue epidemics is a vital aspect in control programmes. Predictions based on larval indices of disease vectors are widely used in dengue control, with defined threshold values. However, there is no set threshold in Sri Lanka at the national or regional levels for Aedes larval indices. Therefore, the current study aimed at developing threshold values for vector indices in two dengue high-risk districts in Sri Lanka. METHODS: Monthly vector indices (House Index [HI], Container Index [CI], Breteau Index for Aedes aegypti [BIagp], and Ae. albopictus [BIalb]), of ten selected dengue high-risk Medical Officer of Health (MOH) areas located in Colombo and Kandy districts, were collected from January 2010 to June 2019, along with monthly reported dengue cases. Receiver Operating Characteristic (ROC) curve analysis in SPSS (version 23) was used to assess the discriminative power of the larval indices in identifying dengue epidemics and to develop thresholds for the dengue epidemic management. RESULTS: Only HI and BIagp denoted significant associations with dengue epidemics at lag periods of one and two months. Based on Ae. aegypti, average threshold values were defined for Colombo as Low Risk (2.4 ≤ BIagp < 3.8), Moderate Risk (3.8 ≤ BIagp < 5), High Risk (BIagp ≥ 5), along with BIagp 2.9 ≤ BIagp < 4.2 (Low Risk), 4.2 ≤ BIagp < 5.3 (Moderate Risk), and BIagp ≥ 5.3 (High Risk) for Kandy. Further, 5.5 ≤ HI < 8.9, 8.9 ≤ HI < 11.9, and HI ≥ 11.9 were defined as Low Risk, Moderate Risk, and High Risk average thresholds for HI in Colombo, while 6.9 ≤ HI < 9.1 (Low Risk), 8.9 ≥ HI < 11.8 (Moderate Risk), and HI ≥ 11.8 (High Risk) were defined for Kandy. CONCLUSIONS: The defined threshold values for Ae. aegypti and HI could be recommended as indicators for early detection of dengue epidemics and to drive vector management activities, with the objective of managing dengue epidemics with optimal usage of financial, technical, and human resources in Sri Lanka.
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    Field-based evaluation of Novaluron EC10 insect growth regulator, a chitin synthesis inhibitor against Dengue vector breeding in leaf axils of pineapple plantations in Gampaha district, Sri Lanka
    (BioMed Central, 2020) Gunathilaka, N.; Ranathunga, T.; Hettiarachchi, D.; Udayanga, L.; Abeyewickreme, W.
    BACKGROUND: Insect growth regulators (IGRs) are considered a novel group of insecticides to control mosquitoes. Novaluron is an IGR with benzoylphenyl urea insecticide, which inhibits chitin synthesis in insects and can reduce insect population density; it is also known to have a high margin of safety for mammals. METHODS: The effective minimum concentration of novaluron formulation EC10 was tested. Six pineapple plantations [control (n = 3) and test (n = 3)] were selected from Meerigama Medical Officer of Health area in Gampaha District, Sri Lanka. Fifteen plots (10 × 10 m) were demarcated in each site with a 200 m distance apart. Leaf axils of 450 pineapple plants (30 plants × 15 plots) were screened for immature stages of Aedes mosquitoes weekly for 12 weeks. The required concentration (20 ppm) of novaluron was sprayed onto the selected pineapple plants (n = 1350) individually in 3 selected test sites for 5-10 s. The reduction in the vector population was interpreted as the percentage of reduction in immature stages of Aedes mosquitoes. RESULTS: The 100% mortality of the Ae. aegypti larvae within 24 h was observed at 20 ppm (0.05 ml of novaluron 100 g/l in 250 ml of water) as the minimum dose. Variation in the number of Aedes larvae present in the control and intervention sites was found to be significantly different throughout the entire observational period (χ2 = 128.29, df = 11, P < 0.001). The total elimination of Aedes larvae continued for up to 2 weeks and a 50% reduction was observed until the 8th week. CONCLUSIONS: The present study emphasizes that novaluron (10% EC) can be used as an effective larvicide at the treatment dose of 20 ppm. The residual effect of the IGR lasted for 12 weeks with a functional efficacy of 8 weeks. The 100% reduction of larval breeding was observed up to the 2nd week after application and the percentage reduction of immature stages remained > 50% until the 8th week. The lowest reduction (34.2%) was observed at 12 weeks after the initial treatment. Therefore, re-treatment may be recommended based on the reduction in the efficacy of the IGR. Keywords: Aedes; Field efficacy; Insect growth regulator; Novaluron; Pineapple plantation.
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    Effect of larval nutritional regimes on morphometry and vectorial capacity of Aedes aegypti for Dengue transmission
    (BioMed Research International, 2019) Gunathilaka, N.; Upulika, H.; Udayanga, L.; Amarasinghe, D.
    BACKGROUND: Nutritional level in larval diet of mosquito vectors influence on life history traits and vectorial capacity (VC). Therefore, the present study was carried out to assess the effect of larval diet concentration on vector bionomic and VC of Aedes aegypti in Sri Lanka. Method. Three batches of 400 Ae. aegypti larvae (first instar) were reared under different concentrations of larval diet (6%, 8%, and 10%; Volume/Volume), which was prepared by mixing 12.5 g of tuna meal, 9.0 g of bovine liver powder, and 3.5 g of Brewer’s yeast, in 100 ml of distilled water. The effect of larval diet concentration on different morphometric and functional parameters of larvae (length and width of head, abdomen, survival rate, and pupation success), pupae (length and width of cephalothorax, survival rate, and adult emersion), adult (length and width of thorax, abdomen, survival rate, longevity, biting frequency and fecundity of adults) were examined. In addition, VC of Ae. aegypti was evaluated. The General Linear Model (GLM) was used for the statistical analysis. Results. Larval head length, head width, thoracic width, abdominal length, abdominal width, total length, and survival rate significantly increased with higher doses of larval diet (P<0.05). In case of pupae, length, and width of cephalothorax, survival rate and adult emergence rate denoted an increasing trend with the elevated larval diets. However, the variations of survival rate and adult emergence rate were statistically significant (P<0.05). In adults, all morphometric parameters (thoracic length, abdominal length, abdominal width, and wing length) significantly increased with elevating larval diets levels (except for thoracic width) along with the biting frequency, fecundity, and survival rate (P<0.05) of adult females. The VC also denoted significant variations (F4,14 = 24.048; ) with the larval diet concentration, whereby the highest VC of 196.37 was observed at 10% treatment. Conclusion. Larval food availability has a significant influence on the adult fitness and thus may affect the incidence of dengue due to variations in the VC of Ae. aegypti. Hence, this investigation highlights the requirement in accounting the environmental variation at the larval stages in order to understand transmission dynamics and control of dengue in Sri Lanka.
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    A Comprehensive analysis on abundance, distribution, and bionomics of potential malaria vectors in Mannar District of Sri Lanka
    (Hindawi Publishing Corporation, 2019) Gunathilaka, N.; Hapugoda, M.; Wickremasinghe, R.; Abeyewickreme, W.
    BACKGROUND:A detailed knowledge of the distribution of the malaria vectors in Mannar district of Sri Lanka has not been studied after 1927. Past records indicated the presence of only seven species of anophelines, namely, An. culicifacies, An. subpictus, An. barbirostris, An. peditaeniatus, An. nigerrimus, An. Jamesii, and An. maculatus. There have been many changes in terms of distribution of Anopheles in the district over time. METHODS: Entomological surveillance was conducted on a monthly basis, comprising indoor hand collection, window trap collection, cattle-baited net collection, cattle-baited hut collection, and larval survey from June 2010 to June 2012 in 12 study areas under three entomological sentinel sites. The relationship between seven abiotic variables of the breeding habitats was measured. Pearson's correlation coefficients were used to determine the associations between climatic variables and anopheline densities. RESULTS:A total of 74,181 mosquitoes belonging to 14 Anopheles species were recorded. An. subpictus was the most predominant species from all techniques representing 92% (n=68,268) of the total anopheline collection. However, Anopheles culicifacies was not recorded from any site during the study period. Larval surveys identified 12 breeding habitat categories including waste water collections, lagoon water collections, and drains which were not recorded as breeding habitats by previous studies. The mean dissolved oxygen level of waste water collections was 3.45±0.15 mg/l. The mean salinity and conductivity of lagoon water collections were 21105±1344 mg/l and 34734±1974 μs/cm, respectively.CONCLUSION: The present study provides the updated knowledge on anopheline distribution and vector bionomics. Therefore, documentation of the current knowledge would be useful for learners and health authorities to design appropriate vector control measures in the prevention of reintroduction of malaria.
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    Empirical optimization of risk thresholds for dengue: an approach towards entomological management of Aedes mosquitoes based on larval indices in the Kandy District of Sri Lanka
    (BioMed Central, 2018) Udayanga, L.; Gunathilaka, N.; Iqbal, M.C.M.; Najim, M.M.M.; Pahalagedara, K.; Abeyewickreme, W.
    BACKGROUND: Larval indices such as Premise Index (PI), Breteau Index (BI) and Container Index (CI) are widely used to interpret the density of dengue vectors in surveillance programmes. These indices may be useful for forecasting disease outbreaks in an area. However, use of the values of these indices as alarm signals is rarely considered in control programmes. Therefore, the current study aims to propose threshold values for vector indices based on an empirical modeling approach for the Kandy District of Sri Lanka. METHODS: Monthly vector indices, viz PI, BI and CI, for Aedes aegypti and Aedes albopictus, of four selected dengue high risk Medical Officer of Health (MOH) areas in the Kandy District from January 2010 to August 2017, were used in the study. Gumbel frequency analysis was used to calculate the exceedance probability of quantitative values for each individual larval index within the relevant MOH area, individually and to set up the threshold values for the entomological management of dengue vectors. RESULTS: Among the study MOH areas, Akurana indicated a relatively high density of both Ae. aegypti and Ae. albopictus, while Gangawata Korale MOH area had the lowest. Based on Ae. aegypti, threshold values were defined for Kandy as low risk (BIagp > 1.77), risk (BIagp > 3.23), moderate risk (BIagp > 4.47) and high risk (BIagp > 6.23). In addition, PI > 6.75 was defined as low risk, while PI > 9.43 and PI>12.82 were defined as moderate and high risk, respectively as an average. CONCLUSIONS: Threshold values recommended for Ae. aegypti (primary vector for dengue) along with cut-off values for PI (for Ae. aegypti and Ae. albopictus), could be suggested as indicators for decision making in vector control efforts. This may also facilitate the rational use of financial allocations, technical and human resources for vector control approaches in Sri Lanka in a fruitful manner.
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